npj Primary Care Respiratory Medicine Articles

Npj Primary Care Respiratory Medicine, a Nature Research Journal is the official Journal of the PCRS and the International Primary Care Group (IPCRG). An online, open access, journal, jointly owned by PCRS and Springer Nature, npj Primary Care Respiratory Medicine is the only indexed scientific journal devoted to the management of respiratory diseases in primary care. The latest content published by the journal can be found below. Visit https://www.nature.com/npjpcrm for the full range of articles and information on how to submit.

Prospective observational cohort study of symptom control prediction in paediatric asthma by using the Royal College of Physicians three questions

Prospective observational cohort study of symptom control prediction in paediatric asthma by using the Royal College of Physicians three questions, Published online: 24 October 2018; doi:10.1038/s41533-018-0107-5

Validated asthma control tests should be used to assess children rather than the ‘three questions’ survey recently developed by the Royal College of Physicians. The UK-based organisation developed the RCP3Q as a practical, rapid way of assessing asthma control in primary care. However, the RCP3Q was never comprehensively trialed for use with children. Erol Gaillard and co-workers at the University of Leicester compared the RCP3Q with three validated tests and questionnaires to determine its efficacy in assessing patients aged 5 to 16. 319 child patients completed the validated tests and their RCP3Q responses were collected immediately afterwards on the same day. In comparison with validated tests, the RCP3Q varied in its accuracy depending on the threshold scores selected. A threshold score of 1 resulted in 25 per cent of participants being misclassified with uncontrolled asthma.

A non-randomised controlled pilot study of clinical pharmacist collaborative intervention for community dwelling patients with COPD

A non-randomised controlled pilot study of clinical pharmacist collaborative intervention for community dwelling patients with COPD, Published online: 10 October 2018; doi:10.1038/s41533-018-0105-7

Clinical pharmacists, working in collaboration with respiratory specialists, can help people who live at home with chronic obstructive pulmonary disease (COPD) better manage their medications and symptoms. In a non-randomised pilot study, Richard Lowrie from the NHS Greater Glasgow and Clyde, UK, and colleagues found that patients with COPD who receive standard at-home care—which includes visits to GP surgeries and hospital-based respiratory out-patient clinics, and visits from respiratory specialist nurses—were more likely to experience exacerbations and need lengthy hospital stays than those who additionally received home visits from a clinical pharmacist. The pharmacist, in consultation with the patient’s respiratory physician, often proposed medication changes and suggested additional testing or referrals that presumably explain the improved health outcomes. The authors conclude that a large, randomised trial is warranted to further evaluate the merits of this collaborative intervention for community dwelling patients with COPD.

Primary care cohort study in the sequence of diagnosing chronic respiratory diseases and prescribing inhaled corticosteroids

Primary care cohort study in the sequence of diagnosing chronic respiratory diseases and prescribing inhaled corticosteroids, Published online: 09 October 2018; doi:10.1038/s41533-018-0106-6

Primary care cohort study in the sequence of diagnosing chronic respiratory diseases and prescribing inhaled corticosteroids

Population-based study of LAMA monotherapy effectiveness compared with LABA/LAMA as initial treatment for COPD in primary care

Population-based study of LAMA monotherapy effectiveness compared with LABA/LAMA as initial treatment for COPD in primary care, Published online: 28 September 2018; doi:10.1038/s41533-018-0102-x

A single rather than combined long-acting inhaler therapy may be adequate for most patients when treating mild to moderate chronic lung disease. Marc Miravitlles at the Hospital Universitari Vall d’Hebron, Barcelona, Spain, and co-workers have shown that, in the initial stages of chronic obstructive pulmonary disease (COPD), treatment with an inhaled drug called a long-acting anti-muscarinic agent (LAMA) is as effective as an alternative inhaler that combines LAMA with another drug (LABA). The researchers identified 5729 COPD patients from Catalonia starting on inhaled treatment in 2015 and followed up on their progress after 1 year. Patients starting on LAMA monotherapy were matched closely in terms of demographics and previous medical history to those starting on LAMA/LABA treatment. The team found no remarkable differences in clinical characteristics between the groups over the year.