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npj Primary Care Respiratory Medicine Articles

The new title for Primary Care Respiratory Journal following an agreement with Nature Publishing Group to re-launch the journal as part of the Nature Partner Journals series.

The use of electronic alerts in primary care computer systems to identify the excessive prescription of short-acting beta2-agonists for people with asthma: a systematic review

The use of electronic alerts in primary care computer systems to identify the excessive prescription of short-acting beta<sub>2</sub>-agonists for people with asthma: a systematic review, Published online: 16 April 2018; doi:10.1038/s41533-018-0080-z

The use of electronic alerts in primary care computer systems to identify the excessive prescription of short-acting beta2-agonists for people with asthma: a systematic review

Recurrent lower respiratory illnesses among young children in rural Kyrgyzstan: overuse of antibiotics and possible under-diagnosis of asthma. A qualitative FRESH AIR study

Recurrent lower respiratory illnesses among young children in rural Kyrgyzstan: overuse of antibiotics and possible under-diagnosis of asthma. A qualitative FRESH AIR study, Published online: 10 April 2018; doi:10.1038/s41533-018-0081-y

Recurrent lower respiratory illnesses among young children in rural Kyrgyzstan: overuse of antibiotics and possible under-diagnosis of asthma. A qualitative FRESH AIR study

'Exacerbation-free time' to assess the impact of exacerbations in patients with chronic obstructive pulmonary disease (COPD): a prospective observational study

'Exacerbation-free time' to assess the impact of exacerbations in patients with chronic obstructive pulmonary disease (COPD): a prospective observational study, Published online: 03 April 2018; doi:10.1038/s41533-018-0079-5

Time spent exacerbation-free may provide a stronger indication of disease burden than exacerbation frequency for patients with chronic lung disease. Exacerbations in chronic obstructive pulmonary disease (COPD) are marked by a sudden decline in lung function, potential hospitalisation and a need to increase medication. Exacerbation frequency is used as a marker in COPD management, but this does not consider the duration of exacerbations or the impact this has on patients’ lives. Lonneke Boer at Radboud University Medical Center, the Netherlands, and co-workers questioned 166 patients every two weeks for a year about their experiences of exacerbation duration and frequency. There was substantial variation in exacerbation-free time between patients, with smokers most likely to suffer longer periods of poorer health. Exacerbation-free time was better correlated with health-related quality of life than exacerbation frequency.

Asbestosis is prevalent in a variety of construction industry trades

Asbestosis is prevalent in a variety of construction industry trades, Published online: 03 April 2018; doi:10.1038/s41533-018-0078-6

Asbestosis is prevalent in a variety of construction industry trades

Improvement in the management of chronic obstructive pulmonary disease following a clinical educational program: results from a prospective cohort study in the Sicilian general practice setting

Improvement in the management of chronic obstructive pulmonary disease following a clinical educational program: results from a prospective cohort study in the Sicilian general practice setting, Published online: 23 March 2018; doi:10.1038/s41533-018-0077-7

An education program for doctors covering chronic lung disease diagnosis and management improves elements of patient care in Italy. Gianluca Trifirò at the University of Messina, Italy, and co-workers followed a cohort of 33 family doctors and 1,465 patients with chronic obstructive pulmonary disease (COPD) in Sicilian primary care for two years, comparing quality of care for patients before and after implementing the education program. The training, led by lung specialists and clinical pharmacologists, updated doctors with the latest information on COPD diagnosis, medication and disease management, and trained them in spirometry test interpretation. The team assessed the value of the program using quality-of-care indicators and asked each doctor to re-evaluate patients’ COPD diagnosis. Their results showed improvement in some areas, including spirometry testing, alongside a reduction in hospital admissions over the two-year period.

Agreement between hospital and primary care on diagnostic labeling for COPD and heart failure in Toronto, Canada: a cross-sectional observational study

Agreement between hospital and primary care on diagnostic labeling for COPD and heart failure in Toronto, Canada: a cross-sectional observational study, Published online: 09 March 2018; doi:10.1038/s41533-018-0076-8

Improving diagnostic labeling across healthcare providers would help develop a more robust database to improve care and inform research. Patient diagnoses for serious conditions, such as heart failure (HF) and chronic obstructive pulmonary disease (COPD), should be documented across care providers, regardless of whether a patient is seen in hospital or local surgery. Consistent labeling of patient charts across providers improves patient services and informs research into clinical practice. Michelle Greiver at North York General Hospital in Toronto, Canada, and co-workers uncovered significant disagreement between a Toronto hospital and its associated primary care providers on labeling of patients with HF or COPD, with the two settings agreeing on labels for a third of patients. Around one fifth of patients had no diagnostic label in either setting, despite suffering from one or other condition.

Fostering the exchange of real world data across different countries to answer primary care research questions: an UNLOCK study from the IPCRG

Fostering the exchange of real world data across different countries to answer primary care research questions: an UNLOCK study from the IPCRG, Published online: 08 March 2018; doi:10.1038/s41533-018-0075-9

Effective management of international primary care data sharing shows great potential to inform clinical practice for multiple diseases. The International Primary Care Research Group (IPCRG) was established in 2000 to progress sharing of big data between countries and support associated research projects. Liza Cragg of IPCRG in the UK and co-workers, reported on progress and limitations faced by one research group, UNLOCK, who are investigating the long-term impacts of chronic lung diseases. Cragg’s team interviewed UNLOCK members and analyzed results of individual research studies undertaken between 2010 and 2016. Constraints highlighted by researchers included inconsistencies across datasets, ethical concerns about data use, difficulties organizing international working groups and the voluntary nature of IPRCG work. Progress was slower than anticipated but several successful studies highlighted the potential for primary care data sharing to provide valuable insights.