{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,28]],"date-time":"2026-10-28T12:37:33Z","timestamp":1793191053899,"version":"4.5.0"},"reference-count":40,"publisher":"BMJ","issue":"2","funder":[{"DOI":"10.13039\/501100006701","name":"Umm-Al Qura University","doi-asserted-by":"crossref","award":["Not Applicable"],"award-info":[{"award-number":["Not Applicable"]}],"id":[{"id":"10.13039\/501100006701","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100000761","name":"Imperial College London","doi-asserted-by":"publisher","award":["Not Applicable"],"award-info":[{"award-number":["Not Applicable"]}],"id":[{"id":"10.13039\/501100000761","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Saudi Arabia Cultural Bureau","award":["Not Applicable"],"award-info":[{"award-number":["Not Applicable"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Thorax"],"accepted":{"date-parts":[[2022,7,20]]},"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Oscillatory positive expiratory pressure (OPEP) devices are intended to facilitate sputum clearance and reduce cough, but there is limited evidence for their effectiveness in COPD, or to guide patient selection. We aimed to assess the impact of OPEP therapy on quality of life and objective measures of cough and sleep disturbance in patients with COPD with regular sputum production.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We enrolled stable patients with COPD, who reported sputum production every day or most days, into an assessor-blind, parallel-group, randomised controlled trial comparing 3\u2009months of using an Acapella device against usual care (including use of the active cycle of breathing technique). The primary outcome was cough-related quality of life measured using the Leicester Cough Questionnaire (LCQ). Secondary outcomes included fatigue (Functional Assessment of Chronic Illness Therapy, FACIT score) and generic quality of life (EuroQol-5 Dimensions, EQ-5D). In a substudy (n=45), objective monitoring of cough and disturbance\/movement during sleep were also available.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>122 participants (61\/61 OPEP\/control) were recruited, 40% female, 17% smokers, FEV1 38 (25\u201356)% predicted, and age 62\u00b110 years. 103 completed the study (55\/48 OPEP\/control). Use of OPEP was associated with an improvement in LCQ compared with controls; MD (95%\u2009CI) 1.03 (0.71 to 2.10); (p=0.03), FACIT score 4.68 (1.34 to 8.02); (p&lt;0.001) and EQ-5D 4.00 (0.49 to 19.75); (p=0.04). There was also an improvement in cough frequency \u221260 (\u221243 to \u221295) coughs\/24 hours (p&lt;0.001), but no statistically significant effect on sleep disturbance was identified.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Regular use of an Acapella device improves symptoms and quality of life in people with COPD who produce sputum daily or most days.<\/jats:p><\/jats:sec><jats:sec><jats:title>Trial registration number<\/jats:title><jats:p><jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"isrctn\" xlink:href=\"ISRCTN44651852\">ISRCTN44651852<\/jats:ext-link>.<\/jats:p><\/jats:sec>","DOI":"10.1136\/thorax-2022-219077","type":"journal-article","created":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T17:28:08Z","timestamp":1660152488000},"page":"136-143","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Oscillatory positive expiratory pressure therapy in COPD (O-COPD): a randomised controlled trial"],"prefix":"10.1136","volume":"78","clinical-trial-number":[{"clinical-trial-number":"isrctn44651852","registry":"10.18810\/isrctn"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6677-1110","authenticated-orcid":false,"given":"Saeed M","family":"Alghamdi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3922-0548","authenticated-orcid":false,"given":"Abdullah S","family":"Alsulayyim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali M","family":"Alasmari","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9614-3580","authenticated-orcid":false,"given":"Keir E J","family":"Philip","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara C","family":"Buttery","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Winston A S","family":"Banya","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1243-8571","authenticated-orcid":false,"given":"Michael I","family":"Polkey","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Surinder S","family":"Birring","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3235-0454","authenticated-orcid":false,"given":"Nicholas S","family":"Hopkinson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,8,10]]},"reference":[{"key":"2024051320304813000_78.2.136.1","doi-asserted-by":"crossref","first-page":"1125","DOI":"10.1007\/s11325-014-1111-9","article-title":"Frequent sputum production is associated with disturbed night's rest and impaired sleep quality in patients with COPD","volume":"19","author":"Hartman","year":"2015","journal-title":"Sleep Breath"},{"key":"2024051320304813000_78.2.136.2","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2016-208900"},{"key":"2024051320304813000_78.2.136.3","doi-asserted-by":"publisher","DOI":"10.1183\/09059180.00004311"},{"key":"2024051320304813000_78.2.136.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2011.12.007"},{"key":"2024051320304813000_78.2.136.5","doi-asserted-by":"crossref","unstructured":"Zwerink M , Brusse-Keizer M , van der Valk PD , et al . 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