Introduction: Chronic obstructive pulmonary disease (COPD) is a serious global health problem that is ranked third among the leading causes of death worldwide. However, underdiagnosis remains common, especially in Spain. The CARABELA-COPD initiative aims to address these issues by optimizing processes across the diverse healthcare settings in Spain.
Material And Methods: CARABELA-COPD employs lean methodology and fosters partnership between scientific societies, industry, clinicians, and managers to improve COPD care. The methodology consists of 4 phases: Phase 1 involved experts analyzing COPD care models and unmet needs; Phase 2, validation and priorization of improvement areas in 7 pilot hospitals, selecting healthcare quality indicators (QIs) in a national meeting; Phase 3, cocreation and refinement of results from a regional perspective; and Phase 4 is ongoing, disseminating the results and implementing them locally.
Results: Initial phases of the initiative have defined a generic patient journey for COPD management from a multidisciplinary approach, identified 7 improvement areas for optimal COPD care, developed 4 care models tailored to different settings, and established QIs that have been validated in national and regional meetings.
Discussion: CARABELA-COPD is a novel practical approach to COPD management in Spain that acts as catalyst for a system transformation to boost overall system efficiency and enhance patient outcomes. It provides a clear framework for improvement, emphasizing interdisciplinary collaboration and communication. The ongoing implementation phase will require flexibility and constant evaluation to further enhance COPD care, ultimately improving patient quality of life and healthcare effectiveness.
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http://dx.doi.org/10.1016/j.opresp.2024.100387 | DOI Listing |
Pulmonology
December 2025
Laboratory of Experimental Therapeutics, LIM-20, Department of Clinical Medicine, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
Background: Chronic obstructive pulmonary disease (COPD) induces an imbalance in T helper (Th) 17/regulatory T (Treg) cells that contributes to of the dysregulation of inflammation. Exercise training can modulate the immune response in healthy subjects.
Objective: We aimed to evaluate the effects of exercise training on Th17/Treg responses and the differentiation of Treg phenotypes in individuals with COPD.
J Res Med Sci
November 2024
Department of Internal Medicine, Isfahan University of Medical Sciences, Isfahan, Iran.
Background: In the present study, we aimed to evaluate the effects of medroxyprogesterone on hospital short clinical outcomes and ABG parameters in patients with chronic obstructive pulmonary disease (COPD) exacerbation under treatments with noninvasive ventilation (NIV) treated with progesterone 15 mg in comparison with placebo.
Materials And Methods: This is a double-blinded clinical trial that was performed in 2020-2021 in Isfahan, Iran, on 60 patients with COPD exacerbation that require NIV. All patients received short-acting beta-agonists, short-acting anticholinergics, systemic corticosteroids, and NIV.
Int J Chron Obstruct Pulmon Dis
January 2025
School of Nursing and Health Sciences Hong Kong Metropolitan University, Hong Kong Special Administrative Region, People's Republic of China.
Background: Persistently high rates of inhaler errors and poor adherence among Chronic Obstructive Pulmonary Disease (COPD) patients contribute to ineffective symptomatic control, high care burdens, and increased healthcare resource utilization.
Objective: This study aimed to report (i) nurses-identified common problems and errors of inhaler use in COPD patients, (ii) nurses' attitudes, practices, training needs and required support in inhaler education.
Methods: An online questionnaire survey was conducted with nurses working in Hong Kong from May to June 2023 using an exponential, non-discriminative snowball sampling strategy.
Respir Res
January 2025
Department of Pneumology and Critical Care Medicine, Thoraxklinik at the University Hospital Heidelberg, Heidelberg, Germany.
Background: In COPD patients with severe right-sided emphysema, complete major and incomplete minor fissure, implantation of one-way valves in both the right upper (RUL) and middle lobes (ML) is a possible approach for endoscopic lung volume reduction. The aim of this retrospective analysis was to evaluate the response to therapy and the complication rate at 90 days (90d-FU) after combined RUL-ML valve implantation.
Methods: This retrospective, monocentric study included all patients from the Thoraxklinik Heidelberg who underwent RUL-ML valve treatment between 2012 and 2023 with available follow-up data.
BMC Pulm Med
January 2025
Pulmonary and Critical Care Medicine, Zhujiang Hospital, Southern Medical University, Guangzhou, Guangdong, China.
Background: Research indicates that obesity can worsen the clinical manifestations of chronic obstructive pulmonary disease (COPD). Timely detection of COPD has the potential to enhance treatment results. This study seeks to investigate the association between a new metabolic indicator, the lipid accumulation product (LAP), and the risk of developing COPD.
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