Chronic Obstructive Pulmonary Disease

Chronic Obstructive Pulmonary Disease

            Chronic Obstructive Pulmonary Disease is an infection that causes the blocking of the airways causing difficulties in breathing. COPD mostly occurs as a combination of two medical conditions; the Obstructive Chronic Bronchitis and the Emphysema. The blockage of the airways is mainly caused by pollutants like cigarette smoke, that create a thick mucus lining on the walls of the windpipe causing difficulties in breathing. Also, the condition may be caused by the damage of alveoli (part of bronchitis where the exchange of gases takes place); a condition that makes the lungs unable to empty gases, and receives fresh gases. The diagnosis of COPD involves a procedure referred to as spirometry where a patient blows into a pipe connected to a machine to measure the rate at which the lungs of an individual can empty gases and refill. A well-defined cure for COPD does not exist, but a series of well-taken treatment steps maintains the condition at a manageable level. The treatment procedure for OCPD includes quitting cigarette smoking, taking COPD medication to manage symptoms, choosing a healthy lifestyle, physical practice as well as disengaging from activities accelerating COPD severity.

Several studies have been done on the control and treatment of COPD and conclusions drawn from the studies used to improve the efficiency of the medication process. Several researchers have proposed different methodologies as being the most effective measures in the prevention and management of COPD.  However, the studies done on COPD contain several gaps that leave unanswered questions as well as a lot of potential areas of interest left unattended thus weakening the already existing field of knowledge.

Strâmbu et al. (2017) researched on the treatment of acute exacerbations in COPD using a single and repeated dose of losmapimod, which is an oral inhibitor. The study involved administering the dose to a group of patients and keenly monitoring the improvements in the rate of gaseous exchange for several days. Overall, 96 per cent of the individuals were able to be monitored throughout the whole study with a four per cent withdrawal rate, which did not have a significant effect on the interpretation of results. The study on the patients was contacted for at least fourteen days before the significant impacts of the medication were noticed. The general conclusion was that short-term treatment with the oral inhibitor showed clinically relevant significant improvement in the volume of air inhaled and exhaled under controlled environment compared to placebo in existing COPD environment at Day 8 of the study. However, the conclusions drawn from the study could suffer from bias since the sample size considered was considerably small and could not adequately represent the vast population of individuals living with OCPD. Also, the study seems to be contacted under the assumption that the medication administered was the only factor contributing to the improvement of patients’ condition and ignored significant details such as patients’ immunity strength and change in lifestyles during the period of study. It would be better that a similar study is contacted in future involving a significantly larger sample as well as taking into consideration the additional factors that could affect the conclusions drawn from the research.

A study was done by Bool et al. (2017) to investigate the efficacy of targeted nutrition as an adjunct to exercise training in COPD. The study was done on eighty-one COPD patients with low muscle mass, admitted to out‐patient pulmonary rehabilitation, which was randomly given oral nutritional supplements, enriched with leucine, vitamin D, and omega‐3 fatty acids throughout four months with supervised training. The researchers aimed at checking whether nutrient supplements affected the training behaviors among COPD patients. The study population involved 51 per cent of males with limited, moderate airflow, low diffusion capacity and normal protein intake. At the end of the four months, a significant improvement was observed in favor of using nutrition to improve body mass, muscle strength and cycle endurance cycle. The immediate conclusion from the study was that high-intensity exercise training improves lower limb muscle strength and exercise performance in COPD patients with initial low muscle mass and moderate airflow obstruction. Also, it was noticed that specific nutritional supplementation had additional effects on nutritional status, aspiratory muscle strength, and physical activity compared with compared with normal nutrition. The limitation on the conclusion drawn from the study is that the sample size was relatively small and significant deviations might be observed upon using a larger sample size.

Kerkhof et al. (2017) researched to assess the association between blood eosinophil counts at stable disease and COPD exacerbations. The motivation behind the study was that the worsening of lung function, impaired quality of life, emergency healthcare use and COPD-related mortality are highly associated with exacerbations. The researchers analyzed data on 64847 patients using a longitudinal data record for patients with at least one year living with OCPD. Upon completion of the study, it was concluded that that blood eosinophil counts are associated with increased risk of moderate and severe exacerbations in patients with COPD. However, the study had some observable gaps; out of 64847 candidates, only 8000 were considered for the study and the study did not consider other patient characteristics that might affect the association between blood eosinophil and exacerbations. For example, cigarette smoking could be a contributing factor to lower exacerbation rate. Similar future researches should consider significant factors that could affect the conclusions drawn such as cigarette smoking and strength of body immunity.

Similarly, a research was done by Miravitlles et al. (2016) to review the international guidelines towards the management of COPD. The study was aimed at an evaluation of COPD treatment guidelines published in several countries in the past seven years with each guideline being reviewed in detail and information about the most important aspects of patient diagnosis, risk stratification and pharmacotherapy was extracted following a standardized process. The researchers found a significant relationship between the treatment goals, criteria for the diagnosis of COPD and the use of long-acting bronchodilators as the cornerstone of treatment among guidelines for COPD management. Also, the researchers found out that the management strategies for COPD were significantly different for different nations. The research, however, faced challenges in that, obtaining data on COPD from different nations proved to be a challenge. The authenticity of the data was however not much reliable since the researchers relied on secondary data which could have been interfered with by other parties for personal gains. In future, researchers doing similar studies should consider using primary data or many reliable data to avoid cases of bias in the conclusions made. Biases could significantly affect policymaking leading to a long term negative impact on the attempt to set strong management strategies for COPD.

The studies reviewed contain several gaps that need to be addressed. One, the size of the sample used in a study affects the generalization of conclusions to the general population. Small sample sizes give a poor presentation of the population, and thus drawn findings might not have any impact on the desired goals. Secondly, most studies use secondary data sources, which could have suffered interference from other parties who could have had different interests in the datasets. Also, the reliability of secondary sources is difficult to ascertain since the collection and recording were done by people who could have been driven by different factors. The recorded fields in secondary fields could also not be made to befit the study in question, and as such, the reliability of secondary data sources becomes questionable. As a recommendation, future studies should consider using significantly larger data samples and preferably primary data sources. The research on COPD is critical because the condition is considerably spreading and the mortality rate is rising day-in-day-out. The studies should consider creating alternative treatment procedures or supplementing the already existing procedures with an aim to reduce the cost burden of managing COPD.