article

Let’s read an article a month – April 2022

by
The cropped screenshot of the first page of the article. It also includes the URL or link to the article.

Every month I read an open-access article. I share the title and associated link with my followers to encourage clinicians to read more articles, stay up to date, and continue to grow.

The objective of this month’s paper is to  “discover whether there is any difference for Trelegy as compared with multiple inhalers use for adherence, symptoms, medication beliefs, and medication attitudes” (p45).

Chronic obstructive pulmonary disease patients’ experience using Trelegy as compared with other inhalers

By Hyfaa Mashaal, Joshua Fogel, Najia Sayedy, Ruchi Jalota Sahota and Jagadish Akella.

Can J Respir Ther Vol 58. Published online at https://www.cjrt.ca on 25 March 2022

Link to the article: https://www.cjrt.ca/wp-content/uploads/cjrt-2021-041.pdf

A few notes about this article

  • This article provides a quick review of COPD and Trelegy ( Fluticasone furotate, umeclidinium and vilanterol) (pp 44-45).
  • I was surprised to see that there was an increased reported symptoms with Trelegy, and no difference with inhaler adherence when compared to the other medication groups (p 46).  
  • Very important to mention that this is a small sample study. The authors do state that different findings were observed with larger sample size studies;  Check out number 27 and 28 items under the reference list:
    • 27. Yu AP, Guérin A, Ponce de Leon D, et al. Therapy persistence and adherence in patients with chronic obstructive pulmonary disease: multiple versus single long-acting maintenance inhalers. J Med Econ 2011;14(4):486–96. doi: 10.3111/13696998.2011.594123.
    • 28. Brandstetter S, Finger T, Fischer W, et al. Differences in medication adherence are associated with beliefs about medicines in asthma and COPD. Clin Transl Allergy 2017;7:39. Doi: 10.1186/s13601- 017-0175-6. 

Happy reading and learning,

Farzad Refahi

April 1st, 2022

https://respiratory.blog/lets-read-an-article-a-month-april-2022/

Let’s read an article a month – March 2022

by
The cropped screenshot of the first page of the article. It also includes the URL or link to the article.

Every month I read an open-access article. I share the title and associated link with my followers to encourage clinicians to read more articles, stay up to date, and continue to grow.

The objective of this month’s paper is to [conduct a comprehensive systematic review, critical appraisal and meta-analysis of all prognostic factories in patients with COVID-19] (p2).

Prognostic factors for adverse outcomes in patients with COVID-19: a field-wide systematic review and meta-analysis

By Vanesa Bellou, Ioanna Tzoulaki, Maarten van Smeden, Karel G.M. Moons, Evangelos Evangelou and Lazaros Belbasis

European Respiratory Journal 2022 59: 2002964; DOI: 10.1183/13993003.02964-2020 https://erj.ersjournals.com/content/59/2/2002964

Link to the article: https://erj.ersjournals.com/content/erj/59/2/2002964.full.pdf

The reasons I found this article interesting

  • The authors emphasized the importance of “adequate and transparent reporting of methodology and findings in future studies to improve the applicability of the evidence” (p8).   More on that under the ‘Recommendations and policy implications’ on page eight. 
  • This study address many prognostic factors and narrow down to a few such as age, sex and smoking history (p7).
  • The authors further discuss some of the predictors such as dyspnea and hospitality rate, oxygen saturation and mortality, and smoking and clinical deterioration (p7).  
  • Also, some of the medications and their prognostic factors were highlighted.  E.g. ACEi, ARBs, immunosuppressive medications etc. 

Happy reading and learning,

Farzad Refahi

March 2, 2022

Let’s read an article a month – March 2022

Let’s read an article a month – February 2022

by
The cropped screenshot of the first page of the article. It also includes the URL or link to the article.

Every month I read an open-access article. I share the title and associated link with my followers to encourage clinicians to read more articles, stay up to date, and continue to grow.
 
This month I found an interesting piece to share with you.  This one falls under the innovation category and is about a product called CleanSweep.  The objective of this paper is to introduce CleanSweep and assess “whether the CleanSweep suction catheter is more efficient for secretion removal than the standard suction catheter” (p.138).  To give a quick description, CleanSweep is a “closed-system suctioning device with an integrated inflatable balloon at its tip. … The balloon is not designed to be inflated with the catheter beyond the distal end of the ETT, and it is only inflated during catheter withdrawal thus “sweeping” the secretions off the interior wall of the ETT” (p.138)
Before you continue, I would like to add a quick disclaimer that this is not an endorsement or a sponsored blog post. Please continue to use products that have been approved by your employer.

Evaluation of a novel endotracheal tube suctioning system incorporating an inflatable sweeper 

By John D. Davies, MA, RRT, Yuh Chin Huang, MD, MHS, and Neil R. MacIntyre, MD.

Can J Respir Ther 2021;57:138–142. doi: 10.29390/cjrt-2021-02

Link to the article: https://www.cjrt.ca/wp-content/uploads/cjrt-2021-026.pdf

Reasons I found this article interesting

  • The device has a physical “sweeping” method for removing secretions in the ETT versus just a suction method.
  • It is a closed suction system and the valve provides three options of ‘locked, suction only mode and suction and balloon mode (p139). 
  • It was published on CJRT, a publication I trust.
  • The authors were clear and transparent about their conflict of interests, on page 141, and also clear about the limitations of their study:
    • “Neither our study nor other studies on mechanical ETT cleaners have been designed to be long enough nor large enough to demonstrate improved clinical outcomes linked to improved secretion removal. To do this will require large expensive randomized controlled trials following many patients over long periods assessing such outcomes as hospital length of stay and even mortality. “ (p141)

Happy reading and learning,

Farzad Refahi

Feb. 6, 2022

https://respiratory.blog/lets-read-an-article-a-month-february-2022/

Let’s read an article a month – January 2022

by
The cropped screenshot of the first page of the article. It also includes the URL or link to the article.

Every month I read an open-access article. Then, I share the title and associated link with my followers. This is to encourage clinicians to read more articles, stay up to date, and continue to grow.

The coexistence of asthma and COPD: risk factors, clinical history and lung function trajectories

By: Alessandro Marcon, Francesca Locatelli, Shyamali C. Dharmage, Cecilie Svanes, Joachim Heinrich, Bénédicte Leynaert, Peter Burney, Angelo Corsico, Gulser Caliskan, Lucia Calciano, Thorarinn Gislason, Christer Janson, Deborah Jarvis, Rain Jõgi, Theodore Lytras, Andrei Malinovschi, Nicole Probst-Hensch, Kjell Toren, Lidia Casas, Giuseppe Verlato, Judith Garcia-Aymerich, and Simone Accordini on behalf of the Ageing Lungs in European Cohorts (ALEC) study

European Respiratory Journal 2021 58: 2004656; DOI: 10.1183/13993003.04656-2020

Link to the article: https://erj.ersjournals.com/content/erj/58/5/2004656.full.pdf

The reasons I found this article interesting 

A detailed study with around 20 years of medical history. A large number of individuals [14864, 9251 and 6122, respectively in ECRHS I, II and III who underwent clinical examinations, from 23 centres] (p4).  Useful observations were presented based on past asthma, current asthma, asthma + COPD, and COPD alone. A recommended article to students, new RRTs and even experienced clinicians.  There are many results, findings and conclusions that I cannot cover in a post. As always, I recommend that you read the full article for yourself.

”Lung function decline for subjects with asthma + COPD could have been mitigated by long-term anti-inflammatory treatment. “ (p9).

“The coexistence of asthma and COPD  seems to be a form of severe asthma with severe asthma with origins early in life, as opposed to COPD alone, which is more linked to adult exposures.”  (p10).

”…COPD without concomitant features of asthma seems predominantly linked to adult-life toxic inhalant exposures.  Exposure avoidance (e.g. through smoking cessation and reduction of pollution exposure in occupational settings) may be particularly beneficial against the development of the “pure COPD” phenotype…” (p10).

Happy reading and learning.

Farzad Refahi

January 01, 2022

Link to the blog post: https://respiratory.blog/lets-read-an-article-a-month-January-2022/

Let’s read an article a month – December 2021

by
The cropped screenshot of the first page of the article. It also includes the URL or link to the article.

Every month I read an open-access article and then I share the associated link with my followers. This is to encourage clinicians to read articles, stay up to date, and grow.

This month’s paper tries to “determine students’ perceived self-efficacy, outcome expectations, barriers, and support to attend a Master of Science in Respiratory Care program” p154.

Students’ perceived self-efficacy, expectations, barriers, and support in enrolling in a master’s degree program in respiratory care

By: Vincent Showalter, MSRC, RRT-RCP, Chris Russian, PhD, RRT, RRT-NPS, RPSGT, RST, FAARC, Joshua Gonzales, DHSc RRT-NPS, RRT-SDS, and Arzu Ari, PhD, RRT, PT, CPFT, FAARC, FCCP  

Canadian Journal of Respiratory Therapy (CJRT) Published online November 29, 2021 

Link to the article: https://www.cjrt.ca/wp-content/uploads/cjrt–2021-020.pdf

I like and support the idea of respiratory therapists growing as individuals and, in turn, improving the field of respiratory therapy.  In my mind, RTs graduate, work for some time and then they may acquire their masters if they are seeking new challenges or a new role.  For example, I know a few RTs who after a few years decided to become Anesthesia Assistants to further specialize in airway management or because they preferred ‘office’ working hours. Some RTs naturally work their way to the managerial role while some decide to study a master’s program to more actively land in managerial or leadership roles.   This article presented to me that there are students who are already planning ahead. Why I didn’t think about that? Perhaps I over-emphasized on barriers such as limitations of money and time.  Maybe it is my thinking that students need to work in the role for about a year to consolidate the learned knowledge and skills from their school training.  Of course, it is a possible path. I just didn’t consider it.  I even know successful and intelligent RTs who studied respiratory therapy after completing their Master’s degree.

Many barriers may prevent students to consider a master’s degree.  An interesting consideration is a comfort in one’s research knowledge. I could see that perspective.  As a practising RT, with a Hons BSc, who tries to read an article a month, I still see an ocean of research related terms, concepts and information to educate myself about. The authors had noted “our results indicate undergraduate research self-efficacy could be improved for the current participants by ensuring early exposure and development of even basic or introductory research abilities and academic writing skills” p157. The authors discuss other solutions that can improve and encourage further education of SRTs.  As always, please take the time to read the article as I cannot touch on all the data and results from the articles.

Happy reading and learning,

Farzad Refahi

December 4th, 2021

https://respiratory.blog/lets-read-an-article-a-month-december-2021/