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Clinical Highlights in Chronic Obstructive Pulmonary Disease (COPD)
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Clinical Highlights in Chronic Obstructive Pulmonary Disease (COPD)

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Respiratory Medicine".

Deadline for manuscript submissions: 30 October 2025 | Viewed by 3351

Special Issue Editors

Prof. Dr. Richard Zuwallack

E-Mail Website
Guest Editor
1. Pulmonary and Critical Care, St Francis Hospital and Medical Center, Hartford, CT 06105, USA
2. University of CT School of Medicine, Farmington, CT 06105, USA
Interests: pulmonary medicine; COPD; pulmonary rehabilitation
Special Issues, Collections and Topics in MDPI journals
Dr. Dimosthenis Lykouras

E-Mail Website
Co-Guest Editor
Department of Respiratory Medicine, University Hospital of Patras, Patras, Greece
Interests: asthma; COPD; obstructive sleep apnea; lung cancer
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are pleased to invite you to participate in the Special Issue entitled “Clinical Highlights in Chronic Obstructive Pulmonary Disease (COPD)” in Journal of Clinical Medicine (ISSN 2077-0383). This is an international, peer-reviewed, open access journal listed on PubMed with an impact factor of 3.0.

Chronic Obstructive Pulmonary Disease (COPD) is a very common respiratory disease and has become a leading cause of morbidity and mortality in adults. Although drug development has provided doctors and patients with safe and effective inhaled treatments, newer studies focus on reducing patients’ symptoms, eliminating exacerbations, and improving activity levels, especially at later stages of the disease.

This Special Issue is open to original research papers, case series, and reviews. We welcome authors to submit papers discussing clinical highlights in Chronic Obstructive Pulmonary Disease. The main topics include but are not limited to: (1) response to inhaled treatments; (2) newer non-inhaled treatments; (3) the use of patient-reported outcomes (PROs); (4) cardiovascular risk in COPD; (5) home spirometry; and (6) respiratory rehabilitation.

Together with the journal’s staff, I will be available to assist you in submitting your manuscript to this Special Issue. Worldwide participation and knowledge sharing are welcome. Should you have any questions, you can contact me directly. Thank you in advance for your interest and trust.

Prof. Dr. Richard Zuwallack
Dr. Dimosthenis Lykouras
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • COPD treatment
  • inhalers
  • patient-reported outcomes
  • COPD rehabilitation
  • cardiovascular risk

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Published Papers (3 papers)

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Research

8 pages, 194 KiB  
Article
Percentage of Discharged COPD Patients with Exclusion Criteria for Participation in Outpatient Pulmonary Rehabilitation
by Hnin H. Oo, Osama Elsankary, Diahann K. Wilcox, Antarpreet Kaur, Jane Z. Reardon, Jose A. Soriano, Debapriya Datta and Richard ZuWallack
J. Clin. Med. 2025, 14(9), 2863; https://doi.org/10.3390/jcm14092863 - 22 Apr 2025
Viewed by 388
Abstract
Background/Objectives: Despite documented benefits across multiple outcome areas, referral and uptake into pulmonary rehabilitation (PR) following discharge after an exacerbation of chronic obstructive pulmonary disease (COPD) is low in many health care systems. Surveys documenting this underutilization may ignore the fact of [...] Read more.
Background/Objectives: Despite documented benefits across multiple outcome areas, referral and uptake into pulmonary rehabilitation (PR) following discharge after an exacerbation of chronic obstructive pulmonary disease (COPD) is low in many health care systems. Surveys documenting this underutilization may ignore the fact of disease severity or comorbidity severe enough to make many patients ineligible based on accepted selection criteria for the intervention. The aim of this study was to evaluate the magnitude of non-eligibility for PR following discharge after a COPD exacerbation. Methods: Medical records of COPD patients discharged over a one-year period in two hospitals were reviewed. Records from 353 patients discharged home were reviewed by six clinicians with experience in respiratory medicine and/or PR, three at each hospital. Results: The mean age of the total sample was 71 ± 12 years; 53% were female. Full concordance (all three reviewers agreed on the eligibility or non-eligibility of each patient) was 73%. Our eligibility criterion (two of three reviewers agreed) for PR was 39%. Categories (%) of non-eligibility criteria included the severity of medical condition(s) (44%), cognitive problems, psychiatric disease or substance abuse (24%), incorrect diagnosis (18%), institutionalized post-discharge (9%), and language barriers (4%) (patients may have been placed into more than one criteria category). Conclusions: Our study indicates that a majority of patients with clinical diagnoses of COPD discharged following exacerbations may not be appropriate referrals to PR based on accepted inclusion and/or exclusion criteria for the intervention. However, even after taking this into account, PR uptake is still critically underutilized. Full article
(This article belongs to the Special Issue Clinical Highlights in Chronic Obstructive Pulmonary Disease (COPD))
10 pages, 1784 KiB  
Article
COPD Assessment Test Score Deterioration as a Predictor of Long-Term Outcomes in Patients Hospitalised for Chronic Obstructive Pulmonary Disease Exacerbation
by Cristhian Alonso Correa-Gutiérrez, Zichen Ji, Irene Milagros Domínguez-Zabaleta, Manuel Delgado-Navarro, Ana López-de-Andrés, Rodrigo Jiménez-García, José Javier Zamorano-León, Luis Puente-Maestu and Javier de Miguel-Díez
J. Clin. Med. 2025, 14(4), 1269; https://doi.org/10.3390/jcm14041269 - 14 Feb 2025
Viewed by 680
Abstract
Background: While severe exacerbations are known to worsen the prognosis of patients with chronic obstructive pulmonary disease (COPD), the extent of this impact based on the degree of deterioration is unclear. COPD Assessment Test (CAT) scores increase during exacerbations, reflecting symptom worsening. This [...] Read more.
Background: While severe exacerbations are known to worsen the prognosis of patients with chronic obstructive pulmonary disease (COPD), the extent of this impact based on the degree of deterioration is unclear. COPD Assessment Test (CAT) scores increase during exacerbations, reflecting symptom worsening. This study aimed to compare healthcare resource utilisation and mortality among patients with COPD after a severe exacerbation, stratified by changes in CAT scores. Methods: This observational study included patients hospitalised for COPD exacerbation. The CAT questionnaire was administered twice: once referring to the time of admission and once to the stable phase. Patients were divided into tertiles based on symptom worsening. A prospective follow-up was conducted to compare emergency room visits, hospital admissions, and survival rates. Results: This study included 50 patients, of whom 30 (60%) were male. Their mean age was 70.5 years (standard deviation [SD]: 9.6), mean forced expiratory volume in the first second (FEV1) was 46.7% (SD: 0.8) of the predicted value, and median CAT score deterioration was 9 points (interquartile range: 5–15.25). Patients in the third tertile had earlier healthcare utilisation than those in the first tertile (emergency room visits: log-rank = 5.27, p = 0.022; hospitalisations: log-rank = 5.27, p = 0.022). Survival rates did not differ significantly among tertiles. Conclusions: Patients with greater CAT score deterioration experienced earlier COPD-related events, suggesting the need for closer monitoring after severe exacerbation. Full article
(This article belongs to the Special Issue Clinical Highlights in Chronic Obstructive Pulmonary Disease (COPD))
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19 pages, 2403 KiB  
Article
Insights from Real-World Evidence on the Use of Inhalers in Clinical Practice
by Myriam Calle Rubio, Pedro José Adami Teppa, Juan Luis Rodríguez Hermosa, Miriam García Carro, José Carlos Tallón Martínez, Consolación Riesco Rubio, Laura Fernández Cortés, María Morales Dueñas, Valeria Chamorro del Barrio, Rafael Sánchez-del Hoyo and Jorge García Aragón
J. Clin. Med. 2025, 14(4), 1217; https://doi.org/10.3390/jcm14041217 - 12 Feb 2025
Viewed by 1808
Abstract
Background: Despite the ongoing innovations and the availability of numerous effective inhaled treatment options, achieving optimal disease control in most patients frequently remains disappointing. Unfortunately, although inhaled therapy is the cornerstone of respiratory disease management, the selection of the most appropriate inhaler is [...] Read more.
Background: Despite the ongoing innovations and the availability of numerous effective inhaled treatment options, achieving optimal disease control in most patients frequently remains disappointing. Unfortunately, although inhaled therapy is the cornerstone of respiratory disease management, the selection of the most appropriate inhaler is still overlooked or underestimated by some healthcare professionals, and inhaler misuse remains a significant challenge in managing chronic respiratory diseases which directly influences patients’ quality of life, clinical outcomes, and risk of disease progression. Materials and Methods: This is a unicentric, observational, cross-sectional study designed to evaluate the inhaled therapy prescribed in hospitalized patients and to analyze device changes after hospitalization, as well as the factors associated with these changes. A single face-to-face visit was performed during the patient’s hospitalization, where the inhaled therapy used prior to hospitalization was evaluated: technique (critical errors), compliance (TAI questionnaire), maximum peak inspiratory flow [PIF (L/min)], and level of inhaler handling-related knowledge. A binary logistic regression model was used to explore the association between changing device at discharge and the other independent variables Results: The inhaler most used during hospitalization was the metered-dose inhaler (MDI) with a chamber (51.9% of patients), with the dry powdered inhalers (DPI) being the inhalers used in 43% of maintenance inhaled therapies in the community setting prior to hospitalization. In addition, 90% of patients showed a maximum PIF ≥ 30 L/min, and 35.6% performed critical inhaler errors. These patients had statistically significantly lower maximum PIF values (52.1 L/min in patients with critical inhaler errors vs. 60.8 L/min without critical inhaler errors; p > 0.001) and were more likely to exhibit poor inhaler compliance compared to those without critical errors (50.5% vs. 31.0%, respectively). More than half of the patients who used MDI with spacer chamber made critical inhaler errors; 69.9% showed regular or poor treatment adherence, although 75.6% demonstrated good knowledge about inhaler handling. Only in 27% of the patients did the healthcare professional change the type of inhaler after hospitalization within clinical practice. The medical and nursing staff responsible for the patient’s hospitalization were not informed of the assessment carried out in the study. The probability of not performing a device change at discharge was lower in patients with previous at-home treatment with combined inhaled therapy with LABA + ICS (OR 0.3 [0.18–0.83], p = 0.016) and in patients under triple inhaled therapy (OR 0.3 [0.17–0.76], p = 0.007). No significant differences were observed in inhaler changes when considering the frequency of critical inhaler errors, inhaler handling-related knowledge or maximum PIF values. Conclusions: Our study highlights the urgent need for a more personalized inhaler selection and consistent monitoring by healthcare professionals to minimize inhaler misuse, increase treatment compliance and adherence, and improve disease management outcomes. It is essential to provide training and promote the role of nursing in the evaluation and education of inhaled therapy. Additionally, the use of standardized approaches and tools, such as the CHECK DIAL, is crucial to facilitate the adaptation of devices to patients’ needs. Full article
(This article belongs to the Special Issue Clinical Highlights in Chronic Obstructive Pulmonary Disease (COPD))
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