Disability and Health Outcomes in COPD

慢性阻塞性肺病的残疾和健康结果

• 批准号: 7434360
• 负责人: Paul D Blanc
• 金额: $ 50.42万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2004
• 资助国家: 美国
• 起止时间: 2004-07-01 至 2011-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7434360
• 关键词: Adrenal Cortex Hormones; Adult; Affect; Age; Anxiety; Breathing; Cardiovascular Diseases; Chronic; Chronic Obstructive Airway Disease; Clinical; Condition; Control Groups; Daily; Deterioration; Development; Diabetes Mellitus; Disease Progression; Early Intervention; Education; Environmental Exposure; Environmental air flow; Ethnic Origin; Exercise; Future; Goals; Health; Health Benefit; Health Maintenance Organizations; Healthcare; Hospitalization; Impaired cognition; Impairment; Income; Indoor Air Pollution; Intervention; Link; Lower Extremity; Lung diseases; Measures; Medical; Mental Depression; Methods; Modeling; Multivariate Analysis; Muscle Weakness; Nicotine; Outcome; Oxygen; Pathology; Pathway interactions; Patients; Performance; Persons; Physical assessment; Population; Prevalence; Prevention; Prevention strategy; Process; Psychological Factors; Public Health; Race; Recruitment Activity; Risk; Risk Factors; Sampling; Screening procedure; Self Efficacy; Severity of illness; Social support; Socioeconomic Status; Staging System; Structure; Telephone Interviews; Testing; Tobacco; Vaccination; Work; Workplace; aged; base; cigarette smoking; cognitive function; cohort; design; disability; follow-up; functional disability; health related quality of life; improved; member; muscle strength; prevent; prospective; pulmonary function; respiratory; sex; smoking cessation; young adult

DESCRIPTION (provided by applicant): Background. COPD is a common chronic health condition. Because current medical treatments have minimal impact on disease progression, a strategy to prevent COPD-related disability would have important clinical and public health benefits. Study Aims. To elucidate the disablement process, we will test a specific conceptual model of how disability develops in COPD. The aims are: (1) To evaluate the impact of respiratory impairment, especially pulmonary function impairment, on the risk of functional limitation in COPD. Using a control group, to elucidate the prevalence of respiratory impairment, functional limitation, and disability that is directly attributable to COPD. (2) In adults with COPD, to delineate the longitudinal effect of functional limitation on the risk of incident disability. We hypothesize that development of functional limitation, and not pulmonary function impairment, is the major determinant of disability. (3) To determine the prospective impact of disability on the risk of future adverse health outcomes. Methods. We will assemble a prospective cohort of 1200 randomly sampled adults with COPD who are members of a large regional health maintenance organization. A matched control group of 300 subjects will be recruited. Subjects will undergo a detailed physical assessment that measures respiratory impairment (e.g., pulmonary function) and functional limitation (e.g., lower extremity function, muscle strength, exercise performance, and cognitive function). Structured telephone interviews will ascertain disability outcomes at baseline and 18-month prospective follow-up. We will also study the modulating effects of specific risk factors and protective factors on the progression from functional limitation to COPD-related disability, including psychological factors, environmental exposures, and health care process factors. Significance. Elucidation of the disablement process is the first step toward designing clinical and public health interventions that target reduction of disability in COPD. By determining the pathway from functional limitation to disability, our goal is to provide a scientific basis for screening and prevention of disability among persons with COPD. Based on this work, intervention strategies can be designed that target reduction of functional limitation and disability to improve downstream health outcomes.

描述（由申请人提供）：背景。慢性阻塞性肺病是一种常见的慢性疾病。由于目前的医学治疗对疾病进展的影响很小，因此预防copd相关残疾的策略将具有重要的临床和公共卫生益处。

项目成果

COPD as a systemic disease: impact on physical functional limitations.

• DOI: 10.1016/j.amjmed.2008.04.030
• 发表时间: 2008-09
• 期刊: AMERICAN JOURNAL OF MEDICINE
• 影响因子: 5.9
• 作者: Eisner, Mark D.;Blanc, Paul D.;Yelin, Edward H.;Sidney, Stephen;Katz, Patricia P.;Ackerson, Lynn;Lathon, Phenius;Tolstykh, Irina;Omachi, Theodore;Byl, Nancy;Iribarren, Carlos
• 通讯作者: Iribarren, Carlos

The COPD Helplessness Index: a new tool to measure factors affecting patient self-management.

慢性阻塞性肺病无助指数：衡量影响患者自我管理因素的新工具。

• DOI: 10.1378/chest.09-0764
• 发表时间: 2010
• 期刊: Chest
• 影响因子: 9.6
• 作者: Omachi,TheodoreA;Katz,PatriciaP;Yelin,EdwardH;Iribarren,Carlos;Knight,SaraJ;Blanc,PaulD;Eisner,MarkD
• 通讯作者: Eisner,MarkD

Socioeconomic status, race and COPD health outcomes.

• DOI: 10.1136/jech.2009.089722
• 发表时间: 2011-01
• 期刊: Journal of epidemiology and community health
• 影响因子: 6.3
• 作者: Eisner MD;Blanc PD;Omachi TA;Yelin EH;Sidney S;Katz PP;Ackerson LM;Sanchez G;Tolstykh I;Iribarren C
• 通讯作者: Iribarren C

Occupational exposures and the risk of COPD: dusty trades revisited.

• DOI: 10.1136/thx.2008.099390
• 发表时间: 2009-01
• 期刊: Thorax
• 影响因子: 10
• 作者: Blanc PD;Iribarren C;Trupin L;Earnest G;Katz PP;Balmes J;Sidney S;Eisner MD
• 通讯作者: Eisner MD

Respiratory and skeletal muscle strength in chronic obstructive pulmonary disease: impact on exercise capacity and lower extremity function.

• DOI: 10.1097/hcr.0b013e3182033663
• 发表时间: 2011-03
• 期刊: Journal of cardiopulmonary rehabilitation and prevention
• 影响因子: 3.8
• 作者: Singer J;Yelin EH;Katz PP;Sanchez G;Iribarren C;Eisner MD;Blanc PD
• 通讯作者: Blanc PD