This systematic review and meta-analysis conducted by Tim Harries and team at Kings College London is the first study to identify an independent effect of inhaled corticosteroid (ICS) use on the reduction in exacerbation risk among patients with COPD, stratified by blood eosinophil count. The quality of the evidence from post-hoc randomised controlled trials was low or very low and the associations were not found in “real-world” observational studies, casting doubts on the clinical utility of this biomarker.

Tim Harries and team at Kings College London also conducted a study of the primary care records of patients with COPD, who had mild or moderate airflow limitation and were prescribed inhaled corticosteroids (ICS), has found that at most 39% of patients would warrant a trial of withdrawal of ICS, according to GOLD guidelines. Correct identification of patients who may be offered a trial of withdrawal of ICS presents a challenge to primary care clinicians. 

Jane Watson from the Anglia Ruskin University has recently published a qualitative paper on understanding the barriers and enablers for primary health care based practitioners when considering the referral of patients with COPD to pulmonary rehabilitation. For further information, contact Jane Watson.You can also read full article online now.

Shakila Peramal discusses the history and value of PR, as well as the challenges and barriers to enrolment of patients in PR programmes. A multifaceted approach to engage patients with PR is suggested that includes using digital technologies, improved communication between clinical teams and an individualised approach.

I would like to let you know that the Hull York Medical School have a new blog which explores the images and sound recordings that make up the Bringing breathlessness into View exhibition and aims to share supportive information to help people live well with breathlessness.

Our first post was about the lady in the roses image shown above and our second post has lots of info on how to live well with breathlessness-including our Guide to living well with breathlessness which you are free to download and use with your patients.

I hope you find the blog interesting and I would love to hear your thoughts and feelings on it, so please leave a reply at the bottom of any of the posts. Feel free to share this blog post with any patients or clinicians that you think might be interested in it, and subscribe to our blog to get the latest posts straight into your inbox.

MoreTrials is a public campaign to make it much easier to do randomised trials in medicine. Over the last 25 years trials have become way too complex and more and more costly. As a result too many trials don't get started, too many don't get completed and too many trials produce unreliable results. It's is all a bit of a mess. Full article on MoreTrials.