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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.

Comparison of glycopyrronium versus tiotropium on the time to clinically important deteriorations in patients with COPD: a post-hoc analysis of randomized trials

Comparison of glycopyrronium versus tiotropium on the time to clinically important deteriorations in patients with COPD: a post-hoc analysis of randomized trials, Published online: 24 May 2018; doi:10.1038/s41533-018-0084-8

A novel inhaled drug shows promise in treating moderate to severe chronic lung disease. Guidelines recommend long-term treatment of chronic obstructive pulmonary disease (COPD) with long-acting muscarinic antagonist (LAMA) inhalers. Tiotropium is a common COPD LAMA. Now, Anthony D’Urzo at the University of Toronto, Canada, together with an international research team, have carried out a pooled analysis of results from four clinical trials to compare the efficacy of a novel LAMA, glycopyrronium, with tiotropium. In these trials, 2936 patients were treated with either glycopyrronium or tiotropium, and the health status of patients using glycopyrronium was also compared with those given a placebo. Glycopyrronium was as effective as tiotropium in delaying or preventing clinically important deteriorations in patient health. The risk of deteriorations was significantly lower in the glycopyrronium group than the placebo group.

Point of care microspirometry to facilitate the COPD diagnostic process in primary care: a clustered randomised trial

Point of care microspirometry to facilitate the COPD diagnostic process in primary care: a clustered randomised trial, Published online: 22 May 2018; doi:10.1038/s41533-018-0083-9

A quick, simple test that can be used by family doctors may help identify patients suffering from chronic obstructive pulmonary disease (COPD). The small, inexpensive microspirometry (MI) kit enables doctors conducting routine appointments to measure the volume of air expelled from patients’ lungs. Lisette van den Bemt at Radboud University Medical Center, the Netherlands, and co-workers worked with two groups of doctors in local practices. Both groups were asked to identify patients over 50 with a smoking history, respiratory problems and no diagnose of asthma and COPD, and start a diagnostic process for COPD. One group was given microspirometers to aid diagnoses. Of 192 patients visiting the MI doctors, 78 were identified and 77 per cent were later listed as COPD or COPD was ruled out. In the other group, 61 out of 224 patients were identified with only 44 per cent listed.

Management of children and young people (CYP) with asthma: a clinical audit report

Management of children and young people (CYP) with asthma: a clinical audit report, Published online: 21 May 2018; doi:10.1038/s41533-018-0087-5

Encouraging self-reflection and best practice can help doctors improve patient care following asthma attacks. A recent UK national review uncovered multiple shortfalls in asthma management. Mark Levy at Harrow Clinical Commissioning Group in London and co-workers conducted a clinical asthma audit to assess the after-care of 291 patients under the age of 19 who had been treated for an asthma attack in Harrow during 2016. Analysis of patient records showed that risks of future attacks were not routinely highlighted during follow-up consultations. Only a third of patients had a personal asthma action plan and only 10 per cent of attacks were followed up within two days. During the audit, doctors from each surgery attended focus groups aimed at encouraging best practice. Following the audit, patient hospital admissions from these surgeries dropped by 16 per cent.

Clinical prediction models to support the diagnosis of asthma in primary care: a systematic review protocol

Clinical prediction models to support the diagnosis of asthma in primary care: a systematic review protocol, Published online: 18 May 2018; doi:10.1038/s41533-018-0086-6

Clinical prediction models to support the diagnosis of asthma in primary care: a systematic review protocol

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.