Does a protocol-based screening for commonly occurring comorbid conditions in patients with COPD (eg. CAD, CHF, depression, sleep apnea) improve management and outcomes for patients with COPD?
Although severely alpha-1 antitrypsin deficiency (PI ZZ) individuals are rare, PI MZ subjects comprise approximately 3% of the US population. Mounting evidence suggests that PI MZ is a significant risk factor for COPD. A clinical trial of COPD exacerbation frequency using AAT augmentation therapy in PI MZ subjects with moderate-to-severe COPD could provide a rationale for AAT augmentation therapy (or small molecule neutrophil ...more »
What is the comparative effectiveness of brief interventions to teach patients respiratory inhaler use (e.g., verbal and written instructions) vs. teach-to-goal interventions (brief interventions plus demonstration of correct technique, patient teach-back, feedback, and repeat instruction if needed) on respiratory inhaler technique and patient-reported outcomes (symptom frequency, activities of daily living, quality of ...more »
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 »
Can Measuring CD31+EMPs predict loss of lung function, provide potential bio marker for accelerated lung function loss, and predict increased risk for atherosclerosis leading to increased risk for cardiovascular events?
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 validity of administrative/billing data to evaluate the quality of COPD care as part of quality improvement initiatives? What care practices can be assessed using these data?
Can a tool be developed to group patients into risk categories for resource utilization?
Challenge the unspoken of high cost, high risk and unclear benefits of current COPD care a. PRCT of lung transplantation vs. optimized medical care b. Noninvasive ventilation for treatment of chronic severe respiratory failure c. Chronic combined vs. de-escalation of chronic bronchodilator therapy to as needed for GOLD stages III-IV d. Self management programs in COPD e. Telemedicine in outpatient management of severe ...more »
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)?
Is there a role for statins and/or ACE-inhibitor medications in patients with more mild COPD who do not present with acute exacerbations?
Implementation of checklist to improve outcomes of COPD patients with acute exacerbations
• Does implementation of a checklist designed to improve the care of patients with COPD exacerbations result in greater adherence to guideline recommendations?
• Does implementation of a checklist designed to improve the care of patients with COPD exacerbations results in improved patient outcomes?