In the new era of once a day inhalers for Asthma and COPD, there is critical need to determine whether delivery of drugs to the lung at night or day have different therapeutic effects and/or side effect profile.
Tiotropium is widely used for COPD, but patients report highly variable responses to this medication. A clinical trial of severe COPD subjects could address both short-term (bronchodilator effect) and intermediate-term (COPD exacerbations) outcomes of this heterogeneous response by examining radiologic (chest CT), clinical (Six Minute Walk, Spirometry), and pharmacogenetic (GWAS) influences on this heterogeneous response. ...more »
Subjects with both COPD and asthma are typically excluded from clinical trials, but they represent an important segment of the chronic airflow obstruction population. Defining this combination diagnosis is difficult, but requiring a significant smoking history (e.g. 10 pack years), chronic airflow obstruction (GOLD stage 2 or greater after bronchodilator), age > 45, and childhood onset of asthma could identify the relevant ...more »
COPD hospitalizations a. Define the pathobiological changes that lead to severe exacerbations that cause hospitalizations b. Define novel clinical and biological phenotypic characterizations of hospitalized patients who fail treatment that results in death or early readmission c. Explore new or understudied therapies for treatment of acute COPD hospitalizations: antioxidant, non-steroidal anti-inflammatory (STATIN or ...more »
What is the comparative effectiveness of a Non-invasive vs. Invasive Positive Pressure
Ventilation Protocol for managing acute respiratory failure due to acute exacerbations of COPD
Cystic fibrosis (CF) and alpha-1 antitrypsin deficiency (AATD) share phenotypic features with common COPD including airflow obstruction and airway mucociliary dysfunction. Although research in CF and AATD has advanced our understanding of those rare diseases, it has yet to explain common COPD. Do Alpha-1 Antitrypsin Deficiency and Cystic Fibrosis Inform COPD? Could therapies currently in use or under development for ...more »
How do we generalize our educational efforts such that multiple co-morbidities and their self-care can be addressed?
How can guideline recommendations be implemented into community practice in a way that is feasible, usable, relevant, and cost-effective? (examples are use of care management, translation of chronic care model, and EMR based tools)
What is the clinical effectiveness of pulmonary rehabilitation in reducing hospital admissions and readmissions, improving health outcomes such as exercise tolerance and dyspnea, and positively impacting patient centered outcomes. Does this effectiveness vary based on the types of settings rehab is conducted in, urban vs rural environments, the components to the program, the timing of the program and the overall support ...more »
Lead a coordinated effort of government, patient advocacy organizations, professional organizations, payers and others to plan and implement a coordinated plan to improve COPD awareness, education for patients and healthcare professionals, treatment strategies, research and data collection, policies and public health infrastructure and programs.
Medical marijuana and COPD
What is the comparative effectiveness of short-term vs. chronic (indefinite) pulmonary rehabilitation on patient-reported outcomes (symptom frequency, activities of daily living, quality of life, sleep quality, exacerbations)?