Diagnosis and management of chronic obstructive pulmonary disease in Serbia: an expert group position statement

References

• Adeloye D, Chua S, Lee C, et al. Global and regional estimates of COPD prevalence: systematic review and meta-analysis. J Glob Health. 2015;5:020415. doi:10.7189/jogh.05.02041526755942
   PubMed Web of Science ®Google Scholar
• Mortality GBD, Causes of Death C. Global, regional, and national age-sex specific all-cause and cause-specific mortality for 240 causes of death, 1990-2013: a systematic analysis for the Global Burden of Disease Study 2013. Lancet. 2015;385:117–171. doi:10.1016/S0140-6736(14)61682-225530442
   PubMed Web of Science ®Google Scholar
• Boricic K, Vasic M, Grozdanov J, et al. Results of the National Health Survey of the Republic of Serbia 2013. Belgrade: Institute of Public Health of Serbia, 2014 Available from: http://www.batut.org.rs/download/publikacije/2013SerbiaHealthSurvey.pdf. Accessed 808, 2019.
   Google Scholar
• Vukoja M, Rebic P, Lazic Z, et al. Early detection of asthma and chronic obstructive pulmonary disease in primary care patients. Med Pregl. 2013;66:46–52.23534300
   PubMedGoogle Scholar
• Milenkovic B, Mitic-Milikic M, Rebic P, et al. Asthma and chronic bronchitis symptoms among adult population of Belgrade. Srp Arh Celok Lek. 2011;139:149–154.21618863
   PubMed Web of Science ®Google Scholar
• Koblizek V, Milenkovic B, Barczyk A, et al. Phenotypes of COPD patients with a smoking history in Central and Eastern Europe: the POPE study. Eur Respir J. 2017;49:1601446.28495687
   PubMed Web of Science ®Google Scholar
• Lazic Z, et al. Serbian National COPD Registry. Unpublished data
   Google Scholar
• Aisanov Z, Avdeev S, Arkhipov V, et al. Russian guidelines for the management of COPD: algorithm of pharmacologic treatment. Int J Chron Obstruct Pulmon Dis. 2018;13:183–187. doi:10.2147/COPD.S15377029386887
   PubMed Web of Science ®Google Scholar
• Miravitlles M, Soler-Cataluna JJ, Calle M, et al. Spanish guidelines for management of chronic obstructive pulmonary disease (GesEPOC) 2017. Pharmacological treatment of stable phase. Arch Bronconeumol. 2017;53:324–335. doi:10.1016/j.arbres.2017.03.01828477954
   PubMed Web of Science ®Google Scholar
• Koblizek V, Chlumsky J, Zindr V, et al. Chronic Obstructive Pulmonary Disease: official diagnosis and treatment guidelines of the Czech Pneumological and Phthisiological Society; a novel phenotypic approach to COPD with patient-oriented care. Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub. 2013;157:189–201. doi:10.5507/bp.2013.03923733084
   PubMed Web of Science ®Google Scholar
• Khan JH, Lababidi HM, Al-Moamary MS, et al. The Saudi guidelines for the diagnosis and management of COPD. Ann Thorac Med. 2014;9:55–76. doi:10.4103/1817-1737.12884324791168
   PubMed Web of Science ®Google Scholar
• Bourbeau J, Bhutani M, Hernandez P, et al. CTS position statement: Pharmacotherapy in patients with COPD – An update. Canadian J Respir Crit Care Sleep Med. 2017;1(4):222–241.
   Web of Science ®Google Scholar
• Zysman M, Chabot F, Housset B, et al, Société de Pneumologie de Langue Française. Pharmacological treatment optimisation for stable COPD: an endless story? Proposals from the Société de Pneumologie de Langue Française. Eur Respir J. 2017;50(4):1701250.29025880
   PubMed Web of Science ®Google Scholar
• Registar pacijenata sa hroničnom opstruktivnom bolešću pluća; 2019 Available from http://www.hobp.rs/login.php?lan=0. Accessed 808, 2019.
   Google Scholar
• Mitic-Milikic M, Vukcevic M, Zvezdin B et al. Nacionalni vodič dobre kliničke prakse za dijagnostiku i lečenja hronične opstruktivne bolesti pluća; 2012 Ministarstvo zdravlja Republike Srbije. Available from: http://www.batut.org.rs/download/aktuelno/klinicka%20praksa/Hronicna%20opstruktivna%20bolest%20pluca.pdf. Accessed 808, 2019.
   Google Scholar
• Jovanovic V, Ivanovic I, Krstic M, et al. Health Statistical Yearbook Of Republic Of Serbia 2017 Belgrade: Institute of Public Health of Serbia, 2018. Available from http://www.batut.org.rs/download/publikacije/pub2017v026.pdf. Accessed 808, 2019.
   Google Scholar
• Miller MR, Hankinson J, Brusasco V, et al. Standardisation of spirometry. Eur Respir J. 2005;26:319–338. doi:10.1183/09031936.05.0003480516055882
   PubMed Web of Science ®Google Scholar
• Vukoja M, Bokan A, Vujasinovic G, et al. The differences in spirometry predictive equations in classifying presence and degree of lung function impairment: which suit fits the best? Lung. 2018;196:87–92. doi:10.1007/s00408-017-0065-729043487
   PubMed Web of Science ®Google Scholar
• From the Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD)-2019 Report; 2019 Available from: https://goldcopd.org/. Accessed 808, 2019.
   Google Scholar
• World Health Organization.  Chronic obstructive pulmonary disease (COPD) 2017 Available from: https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd). Accessed 808, 2019.
   Google Scholar
• Poole PJ, Chacko E, Wood-Baker RW, et al. Influenza vaccine for patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2006 (1);CD002733.
   PubMed Web of Science ®Google Scholar
• Kopsaftis Z, Wood-Baker R, Poole P. Influenza vaccine for chronic obstructive pulmonary disease (COPD). Cochrane Database Syst Rev. 2018;6:CD002733.29943802
   PubMed Web of Science ®Google Scholar
• Tomczyk S, Bennett NM, Stoecker C, et al. Use of 13-valent pneumococcal conjugate vaccine and 23-valent pneumococcal polysaccharide vaccine among adults aged >/=65 years: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR Morb Mortal Wkly Rep. 2014;63:822–825.25233284
   PubMed Web of Science ®Google Scholar
• McCarthy B, Casey D, Devane D, et al. Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2015;2:CD003793.
   PubMed Web of Science ®Google Scholar
• Vogiatzis I, Rochester CL, Spruit MA, et al. Increasing implementation and delivery of pulmonary rehabilitation: key messages from the new ATS/ERS policy statement. Eur Respir J. 2016;47:1336–1341. doi:10.1183/13993003.02151-201527132269
   PubMed Web of Science ®Google Scholar
• Faulkner MA, Lenz TL, Stading JA. Cost-effectiveness of smoking cessation and the implications for COPD. Int J Chron Obstruct Pulmon Dis. 2006;1:279–287.18046865
   PubMedGoogle Scholar
• Lall D, Cason E, Pasquel FJ, et al. Effectiveness of influenza vaccination for individuals with chronic obstructive pulmonary disease (COPD) in Low- and middle-income countries. COPD. 2016;13:93–99. doi:10.3109/15412555.2015.104351826418892
   PubMedGoogle Scholar
• Ilic M. Frequency and effects of seasonal flu vaccines on exacerbations of chronic obstructive pulmonary disease in Serbia. Mil Med Pharm J Serb. 2019;49. doi:10.2298/VSP181214049I
   Google Scholar
• Zhou Y, Zhong NS, Li X, et al. Tiotropium in early-stage chronic obstructive pulmonary disease. N Engl J Med. 2017;377:923–935. doi:10.1056/NEJMoa170022828877027
   PubMed Web of Science ®Google Scholar
• Vogelmeier C, Hederer B, Glaab T, et al. Tiotropium versus salmeterol for the prevention of exacerbations of COPD. N Engl J Med. 2011;364:1093–1103. doi:10.1056/NEJMoa100837821428765
   PubMed Web of Science ®Google Scholar
• Decramer ML, Chapman KR, Dahl R, et al. Once-daily indacaterol versus tiotropium for patients with severe chronic obstructive pulmonary disease (INVIGORATE): a randomised, blinded, parallel-group study. Lancet Respir Med. 2013;1:524–533. doi:10.1016/S2213-2600(13)70158-924461613
   PubMed Web of Science ®Google Scholar
• The Global Strategy for the Diagnosis, Management and Prevention of COPD.Asthma, COPD, and asthma-COPD overlap syndrome; 2015 Available from: https://goldcopd.org/asthma-copd-asthma-copd-overlap-syndrome/
   Google Scholar
• Leung JM, Sin DD. Inhaled corticosteroids in COPD: the final verdict is. Eur Respir J. 2018;52:1801940.
   Google Scholar
• Bafadhel M, McKenna S, Terry S, et al. Blood eosinophils to direct corticosteroid treatment of exacerbations of chronic obstructive pulmonary disease: a randomized placebo-controlled trial. Am J Respir Crit Care Med. 2012;186:48–55. doi:10.1164/rccm.201108-1553OC22447964
   PubMed Web of Science ®Google Scholar
• Hamad GA, Cheung W, Crooks MG, et al. Eosinophils in COPD: how many swallows make a summer? Eur Respir J. 2018;51:1702177.
   Web of Science ®Google Scholar
• Greulich T, Mager S, Lucke T, et al. Longitudinal stability of blood eosinophil count strata in the COPD COSYCONET cohort. Int J Chron Obstruct Pulmon Dis. 2018;13:2999–3002. doi:10.2147/COPD.S16590930319247
   PubMed Web of Science ®Google Scholar
• Calzetta L, Rogliani P, Matera MG, et al. A systematic review with meta-analysis of dual bronchodilation with LAMA/LABA for the treatment of stable COPD. Chest. 2016;149:1181–1196. doi:10.1016/j.chest.2016.02.64626923629
   PubMed Web of Science ®Google Scholar
• Vukoja M, Kopitovic I, Milicic D, et al. Sleep quality and daytime sleepiness in patients with COPD and asthma. Clin Respir J. 2018;12:398–403. doi:10.1111/crj.1252827402309
   PubMed Web of Science ®Google Scholar
• Zvezdin B, Milutinov S, Kojicic M, et al. A postmortem analysis of major causes of early death in patients hospitalized with COPD exacerbation. Chest. 2009;136:376–380. doi:10.1378/chest.08-291819318666
   PubMed Web of Science ®Google Scholar
• Pavord ID, Lettis S, Anzueto A, et al. Blood eosinophil count and pneumonia risk in patients with chronic obstructive pulmonary disease: a patient-level meta-analysis. Lancet Respir Med. 2016;4:731–741. doi:10.1016/S2213-2600(16)30148-527460163
   PubMed Web of Science ®Google Scholar
• Papi A, Vestbo J, Fabbri L, et al. Extrafine inhaled triple therapy versus dual bronchodilator therapy in chronic obstructive pulmonary disease (TRIBUTE): a double-blind, parallel group, randomised controlled trial. Lancet. 2018;391:1076–1084. doi:10.1016/S0140-6736(18)30206-X29429593
   PubMed Web of Science ®Google Scholar
• Chapman KR, Hurst JR, Frent SM, et al. Long-term triple therapy de-escalation to Indacaterol/Glycopyrronium in patients with chronic obstructive pulmonary disease (SUNSET): a randomized, double-blind, triple-dummy clinical trial. Am J Respir Crit Care Med. 2018;198:329–339. doi:10.1164/rccm.201803-0405OC29779416
   PubMed Web of Science ®Google Scholar
• Magnussen H, Disse B, Rodriguez-Roisin R, et al. Withdrawal of inhaled glucocorticoids and exacerbations of COPD. N Engl J Med. 2014;371:1285–1294. doi:10.1056/NEJMoa140715425196117
   PubMed Web of Science ®Google Scholar
• Vestbo J, Papi A, Corradi M, et al. Single inhaler extrafine triple therapy versus long-acting muscarinic antagonist therapy for chronic obstructive pulmonary disease (TRINITY): a double-blind, parallel group, randomised controlled trial. Lancet. 2017;389:1919–1929. doi:10.1016/S0140-6736(17)30188-528385353
   PubMed Web of Science ®Google Scholar
• Siddiqui SH, Guasconi A, Vestbo J, et al. Blood eosinophils: a biomarker of response to extrafine Beclomethasone/Formoterol in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2015;192:523–525. doi:10.1164/rccm.201502-0235LE26051430
   PubMed Web of Science ®Google Scholar
• Watz H, Tetzlaff K, Wouters EF, et al. Blood eosinophil count and exacerbations in severe chronic obstructive pulmonary disease after withdrawal of inhaled corticosteroids: a post-hoc analysis of the WISDOM trial. Lancet Respir Med. 2016;4:390–398. doi:10.1016/S2213-2600(16)00100-427066739
   PubMed Web of Science ®Google Scholar
• Hurst JR, Vestbo J, Anzueto A, et al. Susceptibility to exacerbation in chronic obstructive pulmonary disease. N Engl J Med. 2010;363:1128–1138. doi:10.1056/NEJMoa090988320843247
   PubMed Web of Science ®Google Scholar
• Calverley PMA, Tetzlaff K, Vogelmeier C, et al. Eosinophilia, frequent exacerbations, and steroid response in chronic obstructive pulmonary disease. Am J Respir Crit Care Med. 2017;196:1219–1221. doi:10.1164/rccm.201612-2525LE28306321
   PubMed Web of Science ®Google Scholar
• Lipson DA, Barnhart F, Brealey N, et al. Once-daily single-inhaler triple versus dual therapy in patients with COPD. N Engl J Med. 2018;378:1671–1680. doi:10.1056/NEJMoa171390129668352
   PubMed Web of Science ®Google Scholar
• Singh D, Papi A, Corradi M, et al. Single inhaler triple therapy versus inhaled corticosteroid plus long-acting beta2-agonist therapy for chronic obstructive pulmonary disease (TRILOGY): a double-blind, parallel group, randomised controlled trial. Lancet. 2016;388:963–973. doi:10.1016/S0140-6736(16)31354-X27598678
   PubMed Web of Science ®Google Scholar
• Jones PW, Beeh KM, Chapman KR, et al. Minimal clinically important differences in pharmacological trials. Am J Respir Crit Care Med. 2014;189:250–255. doi:10.1164/rccm.201310-1863PP24383418
   PubMed Web of Science ®Google Scholar
• Hohlfeld JM, Vogel-Claussen J, Biller H, et al. Effect of lung deflation with indacaterol plus glycopyrronium on ventricular filling in patients with hyperinflation and COPD (CLAIM): a double-blind, randomised, crossover, placebo-controlled, single-centre trial. Lancet Respir Med. 2018;6:368–378. doi:10.1016/S2213-2600(18)30054-729477448
   PubMed Web of Science ®Google Scholar
• O’Donnell DE, Casaburi R, Frith P, et al. Effects of combined tiotropium/olodaterol on inspiratory capacity and exercise endurance in COPD. Eur Respir J. 2017;49:1601348.28424359
   PubMed Web of Science ®Google Scholar
• Rabe KF, Calverley PMA, Martinez FJ, et al. Effect of roflumilast in patients with severe COPD and a history of hospitalisation. Eur Respir J. 2017;50:1700158.28679611
   PubMed Web of Science ®Google Scholar
• Martinez FJ, Calverley PM, Goehring UM, et al. Effect of roflumilast on exacerbations in patients with severe chronic obstructive pulmonary disease uncontrolled by combination therapy (REACT): a multicentre randomised controlled trial. Lancet. 2015;385:857–866. doi:10.1016/S0140-6736(14)62410-725684586
   PubMed Web of Science ®Google Scholar
• Chong J, Leung B, Poole P. Phosphodiesterase 4 inhibitors for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2017;9:CD002309.28922692
   PubMed Web of Science ®Google Scholar
• Albert RK, Connett J, Bailey WC, et al. Azithromycin for prevention of exacerbations of COPD. N Engl J Med. 2011;365:689–698. doi:10.1056/NEJMoa110462321864166
   PubMed Web of Science ®Google Scholar
• Kelly C, Chalmers JD, Crossingham I, et al. Macrolide antibiotics for bronchiectasis. Cochrane Database Syst Rev. 2018;3:CD012406.29543980
   PubMedGoogle Scholar
• Herath SC, Normansell R, Maisey S, et al. Prophylactic antibiotic therapy for chronic obstructive pulmonary disease (COPD). Cochrane Database Syst Rev. 2018;10:CD009764.30376188
   PubMed Web of Science ®Google Scholar
• Poole P, Chong J, Cates CJ. Mucolytic agents versus placebo for chronic bronchitis or chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2015;5;CD001287.
   Google Scholar
• Zheng JP, Wen FQ, Bai CX, et al. Twice daily N-acetylcysteine 600 mg for exacerbations of chronic obstructive pulmonary disease (PANTHEON): a randomised, double-blind placebo-controlled trial. Lancet Respir Med. 2014;2:187–194. doi:10.1016/S2213-2600(13)70286-824621680
   PubMed Web of Science ®Google Scholar
• Struik FM, Lacasse Y, Goldstein R, et al. Nocturnal non-invasive positive pressure ventilation for stable chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2013;6:CD002878.
   PubMed Web of Science ®Google Scholar
• Crimi C, Noto A, Princi P, et al. Domiciliary non-invasive ventilation in COPD: an international survey of indications and practices. COPD. 2016;13:483–490. doi:10.3109/15412555.2015.110896026744042
   PubMedGoogle Scholar
• Duiverman ML. Noninvasive ventilation in stable hypercapnic COPD: what is the evidence? ERJ Open Res. 2018;4:00012–2018. doi:10.1183/23120541.00012-2018
   Google Scholar
• Kohnlein T, Windisch W, Kohler D, et al. Non-invasive positive pressure ventilation for the treatment of severe stable chronic obstructive pulmonary disease: a prospective, multicentre, randomised, controlled clinical trial. Lancet Respir Med. 2014;2:698–705. doi:10.1016/S2213-2600(14)70153-525066329
   PubMed Web of Science ®Google Scholar
• Liao H, Pei W, Li H, et al. Efficacy of long-term noninvasive positive pressure ventilation in stable hypercapnic COPD patients with respiratory failure: a meta-analysis of randomized controlled trials. Int J Chron Obstruct Pulmon Dis. 2017;12:2977–2985. doi:10.2147/COPD.S14842229066879
   PubMed Web of Science ®Google Scholar
• Murphy PB, Rehal S, Arbane G, et al. Effect of home noninvasive ventilation with oxygen therapy vs oxygen therapy alone on hospital readmission or death after an acute COPD exacerbation: a randomized clinical trial. JAMA. 2017;317:2177–2186. doi:10.1001/jama.2017.445128528348
   PubMed Web of Science ®Google Scholar
• McNicholas WT. COPD-OSA overlap syndrome: evolving evidence regarding epidemiology, clinical consequences, and management. Chest. 2017;152:1318–1326. doi:10.1016/j.chest.2017.04.16028442310
   PubMed Web of Science ®Google Scholar
• Marin JM, Soriano JB, Carrizo SJ, et al. Outcomes in patients with chronic obstructive pulmonary disease and obstructive sleep apnea: the overlap syndrome. Am J Respir Crit Care Med. 2010;182:325–331. doi:10.1164/rccm.200912-1869OC20378728
   PubMed Web of Science ®Google Scholar
• Vermylen JH, Szmuilowicz E, Ravi Kalhan R. Palliative care in COPD: an unmet area for quality improvement. Int J Chron Obstruct Pulmon Dis. 2015;10:1543–1551. doi:10.2147/COPD.S7464126345486
   PubMed Web of Science ®Google Scholar
• Curtis JR. Palliative and end-of-life care for patients with severe COPD. Eur Respir J. 2008;32:796–803. doi:10.1183/09031936.0012610717989116
   PubMed Web of Science ®Google Scholar
• Smith LE, Moore E, Ali I, et al. Prognostic variables and scores identifying the end of life in COPD: a systematic review. Int J Chron Obstruct Pulmon Dis. 2017;12:2239–2256. doi:10.2147/COPD.S13786828814852
   PubMed Web of Science ®Google Scholar
• Barnes PJ. Asthma-COPD Overlap. Chest. 2016;149:7–8. doi:10.1016/j.chest.2015.08.01726757281
   PubMed Web of Science ®Google Scholar
• Rossi A, Guerriero M, Corrado A, et al. Withdrawal of inhaled corticosteroids can be safe in COPD patients at low risk of exacerbation: a real-life study on the appropriateness of treatment in moderate COPD patients (OPTIMO). Respir Res. 2014;15:77. doi:10.1186/1465-9921-15-7725005873
   PubMed Web of Science ®Google Scholar
• Wise RA, Calverley PM, Carter K, et al. Seasonal variations in exacerbations and deaths in patients with COPD during the TIOSPIR((R)) trial. Int J Chron Obstruct Pulmon Dis. 2018;13:605–616. doi:10.2147/COPD.S14839329497289
   PubMed Web of Science ®Google Scholar
• Laube BL, Janssens HM, de Jongh FH, et al. What the pulmonary specialist should know about the new inhalation therapies. Eur Respir J. 2011;37:1308–1331. doi:10.1183/09031936.0016641021310878
   PubMed Web of Science ®Google Scholar
• Chrystyn H, van der Palen J, Sharma R, et al. Device errors in asthma and COPD: systematic literature review and meta-analysis. NPJ Prim Care Respir Med. 2017;27:22. doi:10.1038/s41533-017-0016-z28373682
   PubMed Web of Science ®Google Scholar
• Usmani OS, Lavorini F, Marshall J, et al. Critical inhaler errors in asthma and COPD: a systematic review of impact on health outcomes. Respir Res. 2018;19:10. doi:10.1186/s12931-017-0710-y29338792
   PubMed Web of Science ®Google Scholar
• Melani AS, Bonavia M, Cilenti V, et al. Inhaler mishandling remains common in real life and is associated with reduced disease control. Respir Med. 2011;105:930–938. doi:10.1016/j.rmed.2011.01.00521367593
   PubMed Web of Science ®Google Scholar
• Sanchis J, Gich I, Pedersen S, et al. Systematic review of errors in inhaler use: has patient technique improved over time? Chest. 2016;150:394–406. doi:10.1016/j.chest.2016.03.04127060726
   PubMed Web of Science ®Google Scholar
• Molimard M, Raherison C, Lignot S, et al. Chronic obstructive pulmonary disease exacerbation and inhaler device handling: real-life assessment of 2935 patients. Eur Respir J. 2017;49:1601794.28182569
   PubMed Web of Science ®Google Scholar
• Dudvarski Ilic A, Zugic V, Zvezdin B, et al. Influence of inhaler technique on asthma and COPD control: a multicenter experience. Int J Chron Obstruct Pulmon Dis. 2016;11:2509–2517.27785007
   PubMed Web of Science ®Google Scholar
• Miravitlles M, Montero-Caballero J, Richard F, et al. A cross-sectional study to assess inhalation device handling and patient satisfaction in COPD. Int J Chron Obstruct Pulmon Dis. 2016;11:407–415. doi:10.2147/COPD.S9111827013871
   PubMed Web of Science ®Google Scholar
• Haidl P, Heindl S, Siemon K, et al. Inhalation device requirements for patients’ inhalation maneuvers. Respir Med. 2016;118:65–75. doi:10.1016/j.rmed.2016.07.01327578473
   PubMed Web of Science ®Google Scholar
• Mahler DA. Peak inspiratory flow rate as a criterion for dry powder inhaler use in chronic obstructive pulmonary disease. Ann Am Thorac Soc. 2017;14:1103–1107. doi:10.1513/AnnalsATS.201702-156PS28481631
   PubMed Web of Science ®Google Scholar
• Bosnic-Anticevich S, Chrystyn H, Costello RW, et al. The use of multiple respiratory inhalers requiring different inhalation techniques has an adverse effect on COPD outcomes. Int J Chron Obstruct Pulmon Dis. 2017;12:59–71. doi:10.2147/COPD.S11719628053517
   PubMed Web of Science ®Google Scholar
• Dantic DE. A critical review of the effectiveness of ‘teach-back’ technique in teaching COPD patients self-management using respiratory inhalers. Health Educ J. 2014;73:41–50. doi:10.1177/0017896912469575
   Web of Science ®Google Scholar