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For pharmacist-recom- mended products, go to OTCGuide.net. MORE @ OTCGUIDE. NET W WATCH DISEASE STATE MANAGEMENT COPD Psychological Conditions Increase Early Hospital Readmission Rate in Patients with COPD P atients who develop a psychological condition such as depression, anxi- ety, psychosis, or alcohol/drug abuse are more likely to be readmitted early to a hospital for complications related to chronic obstructive pulmonary disease (COPD), recent study results suggest. The study, published in CHEST Journal, examined data on a sample of Medicare beneficiaries from 2001 to 2011. During this time, 80,088 fee-for-service Medicare patents were hospitalized 135,498 times for COPD; in 30,218 (22%) of these hospitalizations, the admit- ted patient had 1 or more psychological conditions. The research team found that the rate of early readmission was 5% to 14% higher for patients with at least 1 psychological condition than it was for those who had not developed a psychological condition, with readmission rates proving even higher for patients who had more than 1 psychological condition and a low income level. Patients with at least 1 psychological condi- tion also spent a longer initial length of time in the hospital and had a lower rate of outpatient follow-up visits within the first month after discharge com- pared with those who lacked a psychological condition. "Because of the complexity of this situation, hospitals and health care providers need more guidance to reduce readmission in patients with COPD, and it may not be practical to penalize hospitals for higher early readmission rates," said study author Gurinder Singh, MD, in a press release. "More stud- ies are needed in this area." COPD More Prevalent in Rural and Poor Areas of United States P atients who live in low- income or rural areas of the United States may face a greater risk of developing chronic obstructive pulmonary disease (COPD), according to recent study results pre- sented at the 2015 American Thoracic Society International Conference. Seeking to identify potential COPD risk factors, the research team analyzed data from the National Health Interview Survey, the US Census, and the National Center for Health Statistics Urban-Rural Classifi- cation Scheme on 87,701 partic- ipants, including a population- based sample of adults older than 40 years. In particular, the team focused their efforts on examining community and individual-based factors such as region, census level poverty, urban/rural residence, fuel sources, age, sex, race/ethnic- ity, smoking years, household income, home ownership, and education status. The researchers determined that the prevalence of COPD was 11.9% in small metro/rural- poor communities compared with 7.2% among all study par- ticipants. However, they found that community poverty was no longer a significant factor after accounting for individual income. "Findings suggest regional differences and the need for future disparities research to understand the potential con- tribution of occupational expo- sures, fuel sources, and indoor air pollutants to COPD preva- lence in poor, rural areas," the study authors concluded. n COPD Linked to Higher Lung Cancer Risk Among Smokers A lthough smoking is a well-known risk factor for lung cancer, the results of a recent study indicate that smokers with chronic obstruc- tive pulmonary disease (COPD) face a significantly higher risk of developing lung cancer than smokers without the respiratory condition. The study, published in EBioMedicine, analyzed data from 24 previous studies that enrolled a total of 4346 patients with small cell lung cancer (SCLC), which accounts for 15% to 18% of lung cancers worldwide, and 37,942 individuals without the disease. After examining the participants' smoking history, the researchers determined that patients who smoked a pack a day for less than 20 years were 4 times as likely to develop SCLC as nonsmokers, while those who smoked a pack a day for more than 80 years had a nearly 70-fold higher SCLC risk. Additionally, smokers with COPD were 1.86 times more likely to develop SCLC than smokers without COPD, with COPD accounting for 8% of SCLC cases among smokers. "This work suggests that we need to tease out the mechanisms by which COPD may increase lung cancer risk in smokers and to conduct clinical trials to determine whether treating COPD in former and current smokers lessens that risk," said senior author David Christiani, MD, in a press release. 86 PharmacyTimes.com December 2015