What barriers and facilitators modify the effectiveness of smoking cessation programs in patients with COPD?
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?
Develop large epidemiologic cohorts of subjects with various types of chronic lung diseases with long-term follow-up of elements of disease progression and of related co-morbidities. These cohorts should be the substrate for comprehensive studies of genetics, omics, and biomarkers, as well as for clinical trials.
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)?
What is the standard of care for stable COPD and acute exacerbation of COPD that should constitute the reference base for clinical trials?
What factors serve as barriers / facilitators for patient adherence to pulmonary rehabilitation for COPD care?
Can a tool be developed to group patients into risk categories for resource utilization?
Incorporate important co-morbidities of COPD into treatment guidelines. This becomes crucially important with cardiovascular disease (CVD) which shares risk factors and pathogenesis
How do we generalize our educational efforts such that multiple co-morbidities and their self-care can be addressed?
How can we increase physical activity in our COPD patients?
1) Refinement of COPD subphenotypes for therapeutics, diagnostics and mechanistic interrogation. The NIH should encourage a strong focus on a) rigorous, mechanistically-reinforced definitions (chronic bronchitis, emphysema (with and without obstruction), frequent exacerbators, combined pulmonary fibrosis and emphysema) and 2) the development and optimization of animal model systems that replicate the different subphenotypes. ...more »
Define the pathobiology of the disorder (COPD)
a. Mechanisms of lung injury
b. Mechanisms of lung repair
c. Balance of lung and systemic pathobiologic manifestations and mechanisms
Early detection and treatment of COPD
a. Best tests to detect
b. Impact of early treatment
c. Impact of early treatment on disease progression
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 »
Does palliative care and/or hospice care as practiced across communities improve end-of-life care for COPD – specifically, does it reduce the burden of symptoms, improve HRQoL and satisfaction, reduce utilization in last 6 months of life (i.e. hospital visits, cost, invasive ventilation use, etc), improve the end-of-life experience, and increase the concordance of place of death to expressed patient preferences?