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type=\u0022text\/css\u0022 rel=\u0022stylesheet\u0022 href=\u0022\/\/d282kpwvnogo5m.cloudfront.net\/sites\/default\/files\/cdn\/css\/http\/css_Xg7z6oCTVgud_Q0huYz9x9iiD5H_2YPSJ5z2ZViSWdY.css\u0022 media=\u0022all\u0022 \/\u003E\n\u003Clink rel=\u0027stylesheet\u0027 type=\u0027text\/css\u0027 href=\u0027\/sites\/all\/modules\/contrib\/panels\/plugins\/layouts\/onecol\/onecol.css\u0027 \/\u003E\u003C\/head\u003E\u003Cbody\u003E\u003Cdiv class=\u0022panels-ajax-tab-panel panels-ajax-tab-panel-sageoa-tab-art\u0022\u003E\u003Cdiv class=\u0022panel-display panel-1col clearfix\u0022 \u003E\n  \u003Cdiv class=\u0022panel-panel panel-col\u0022\u003E\n    \u003Cdiv\u003E\u003Cdiv class=\u0022panel-pane pane-highwire-markup\u0022 \u003E\n  \n      \n  \n  \u003Cdiv class=\u0022pane-content\u0022\u003E\n    \u003Cdiv class=\u0022highwire-markup\u0022\u003E\u003Cdiv xmlns=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022 id=\u0022content-block-markup\u0022 xmlns:xhtml=\u0022http:\/\/www.w3.org\/1999\/xhtml\u0022\u003E\u003Cdiv class=\u0022article fulltext-view \u0022\u003E\u003Cspan class=\u0022highwire-journal-article-marker-start\u0022\u003E\u003C\/span\u003E\u003Cdiv class=\u0022section abstract\u0022 id=\u0022abstract-1\u0022\u003E\u003Ch2\u003ESummary\u003C\/h2\u003E\n            \u003Cp id=\u0022p-1\u0022\u003EPatients with chronic obstructive pulmonary disease (COPD) who were managed in primary care settings achieved improvements in physical functioning that were similar to those that were observed in clinical trials of combination therapy with tiotropium+salmeterol. The findings extend the clinical trial results in a carefully controlled treatment environment to an unselected patient population in a real-life clinical setting.\u003C\/p\u003E\n         \u003C\/div\u003E\u003Cul class=\u0022kwd-group\u0022\u003E\u003Cli class=\u0022kwd\u0022\u003Enursing\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Echronic obstructive pulmonary disease\u003C\/li\u003E\u003Cli class=\u0022kwd\u0022\u003Epulmonary clinical trials\u003C\/li\u003E\u003C\/ul\u003E\u003Cdiv class=\u0022section\u0022 id=\u0022sec-1\u0022\u003E\n         \n         \u003Cp id=\u0022p-2\u0022\u003EPatients with chronic obstructive pulmonary disease (COPD) who were managed in primary care settings achieved improvements in physical functioning that were similar to those that were observed in clinical trials of combination therapy with tiotropium+salmeterol.\u003C\/p\u003E\n         \u003Cp id=\u0022p-3\u0022\u003EThe findings extend the clinical trial results in a carefully controlled treatment environment to an unselected patient population in a real-life clinical setting, according to a report by Thomas Glaab, MD, and Heike Rau-Berger, Boehringer Ingelheim Pharma, Frankfurt, Germany.\u003C\/p\u003E\n         \u003Cp id=\u0022p-4\u0022\u003ETo compare the clinical trial and clinical practice experience, 230 office-based pulmonologists in Germany enrolled 1280 patients with COPD who required treatment with a long-acting bronchodilator. Patients initiated treatment with tiotropium at a dose of 5 \u03bcg daily (two 2.5 \u03bcg puffs) and returned for a follow-up evaluation after 6 weeks.\u003C\/p\u003E\n         \u003Cp id=\u0022p-5\u0022\u003EAt baseline and Week 6, physical function was assessed by the 10-item Physical Function (PF-10) Subdomain of the Short Form-36 health status questionnaire. Possible total scores on the assessment ranged from 0 to 100. The primary endpoint of the study was therapeutic success at Week 6, defined as a 10-point increase in the PF-10, validated as the minimally important difference for the PF-10.\u003C\/p\u003E\n         \u003Cp id=\u0022p-6\u0022\u003EPrincipal secondary outcomes were absolute change in PF-10 score, change in Physician\u0027s Global Evaluation (PGE) from baseline to Week 6, and patient satisfaction with treatment, assessed by means of a 7-point scale with a range of \u201cvery satisfied\u201d to \u201cvery dissatisfied.\u201d Investigators also analyzed the results according to patient smoking status.\u003C\/p\u003E\n         \u003Cp id=\u0022p-7\u0022\u003EMen accounted for about 60% of the total patient population, 35% of whom were current smokers and 48% former smokers. Current smokers averaged 39 pack-years, and ex-smokers had a cumulative exposure of 33 pack-years.\u003C\/p\u003E\n         \u003Cp id=\u0022p-8\u0022\u003EThe study population had a mean PF-10 score of 49 at baseline. After 6 weeks of treatment, 61.5% of patients achieved therapeutic success. The rate did not differ between current\/former smokers (61.4%) and nonsmokers (61.6%).\u003C\/p\u003E\n         \u003Cp id=\u0022p-9\u0022\u003EThe absolute change in PF-10 scores averaged 13.4, representing a statistically significant improvement from baseline (p\u0026lt;0.001; \u003Ca id=\u0022xref-fig-1-1\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). The change in PF-10 averaged 12.7 among smokers (p\u0026lt;0.001) and 13.7 among nonsmokers (p\u0026lt;0.001; \u003Ca id=\u0022xref-fig-1-2\u0022 class=\u0022xref-fig\u0022 href=\u0022#F1\u0022\u003EFigure 1\u003C\/a\u003E). The mean absolute change did not differ significantly between smokers and nonsmokers.\u003C\/p\u003E\n         \u003Cdiv id=\u0022F1\u0022 class=\u0022fig pos-float  odd\u0022\u003E\u003Cdiv class=\u0022highwire-figure\u0022\u003E\u003Cdiv class=\u0022fig-inline-img-wrapper\u0022\u003E\u003Cdiv class=\u0022fig-inline-img\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/10\/3\/6\/F1.large.jpg?width=800\u0026amp;height=600\u0026amp;carousel=1\u0022 title=\u0022Absolute Change in PF-10 Scores.\u0022 class=\u0022fragment-images colorbox-load\u0022 rel=\u0022gallery-fragment-images-1286263030\u0022 data-figure-caption=\u0022Absolute Change in PF-10 Scores.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003E\u003Cimg class=\u0022fragment-image\u0022 alt=\u0022Figure 1.\u0022 src=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/10\/3\/6\/F1.medium.gif\u0022\/\u003E\u003C\/a\u003E\u003C\/div\u003E\u003C\/div\u003E\u003Cul class=\u0022highwire-figure-links inline\u0022\u003E\u003Cli class=\u00220 first\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/10\/3\/6\/F1.large.jpg?download=true\u0022 class=\u0022highwire-figure-link highwire-figure-link-download\u0022 title=\u0022Download Figure 1.\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload figure\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00221\u0022\u003E\u003Ca href=\u0022http:\/\/d282kpwvnogo5m.cloudfront.net\/content\/spmdc\/10\/3\/6\/F1.large.jpg\u0022 class=\u0022highwire-figure-link highwire-figure-link-newtab\u0022 target=\u0022_blank\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EOpen in new tab\u003C\/a\u003E\u003C\/li\u003E\u003Cli class=\u00222 last\u0022\u003E\u003Ca href=\u0022\/highwire\/powerpoint\/11250\u0022 class=\u0022highwire-figure-link highwire-figure-link-ppt\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EDownload powerpoint\u003C\/a\u003E\u003C\/li\u003E\u003C\/ul\u003E\u003C\/div\u003E\u003Cdiv class=\u0022fig-caption attrib\u0022\u003E\u003Cspan class=\u0022fig-label\u0022\u003EFigure 1.\u003C\/span\u003E \n               \u003Cp id=\u0022p-10\u0022 class=\u0022first-child\u0022\u003EAbsolute Change in PF-10 Scores.\u003C\/p\u003E\n            \u003Cq class=\u0022attrib\u0022 id=\u0022attrib-1\u0022\u003EReproduced with permission from T. Glaab, MD.\u003C\/q\u003E\u003Cdiv class=\u0022sb-div caption-clear\u0022\u003E\u003C\/div\u003E\u003C\/div\u003E\u003C\/div\u003E\n         \u003Cp id=\u0022p-11\u0022\u003EPGE scores reflected a change in patients\u0027 general condition during the 6-week treatment period. The proportion of patients who were rated as poor (score of 1 or 2) declined from 16.2% to 3.0%, and the proportion that was rated as good increased from 23% to 54.6%.\u003C\/p\u003E\n         \u003Cp id=\u0022p-12\u0022\u003EWith regard to patient satisfaction, 76.9% was satisfied or very satisfied with the inhalation device.\u003C\/p\u003E\n         \u003Cp id=\u0022p-13\u0022\u003EAdverse events were reported by 4% of patients, and 0.5% of patients had serious adverse events. Adverse events led to discontinuation in 2.8% of patients. No patients died during the study.\u003C\/p\u003E\n      \u003C\/div\u003E\u003Cul class=\u0022copyright-statement\u0022\u003E\u003Cli class=\u0022fn\u0022 id=\u0022copyright-statement-1\u0022\u003E\u00a9 2010 MD Conference Express\u003C\/li\u003E\u003C\/ul\u003E\u003Cspan class=\u0022highwire-journal-article-marker-end\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Cspan id=\u0022related-urls\u0022\u003E\u003C\/span\u003E\u003C\/div\u003E\u003Ca href=\u0022http:\/\/mdc.sagepub.com\/content\/10\/3\/6.abstract\u0022 class=\u0022hw-link hw-link-article-abstract\u0022 data-icon-position=\u0022\u0022 data-hide-link-title=\u00220\u0022\u003EView Summary\u003C\/a\u003E\u003C\/div\u003E  \u003C\/div\u003E\n\n  \n  \u003C\/div\u003E\n\u003C\/div\u003E\n  \u003C\/div\u003E\n\u003C\/div\u003E\n\u003C\/div\u003E\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_figures.js?nzmsr1\u0022\u003E\u003C\/script\u003E\n\u003Cscript type=\u0022text\/javascript\u0022 src=\u0022http:\/\/mdc.sagepub.com\/sites\/all\/modules\/highwire\/highwire\/plugins\/highwire_markup_process\/js\/highwire_openurl.js?nzmsr1\u0022\u003E\u003C\/script\u003E\n\u003C\/body\u003E\u003C\/html\u003E"}