{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T18:15:56Z","timestamp":1792001756257,"version":"4.4.0"},"reference-count":39,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2023,1,1]],"date-time":"2023-01-01T00:00:00Z","timestamp":1672531200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"AstraZeneca China"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ther Adv Respir Dis"],"published-print":{"date-parts":[[2023,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Chronic obstructive pulmonary disease (COPD) management in China is far from adequate; underdiagnosis and undertreatment are major barriers to optimal care and improved patient outcomes.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective:<\/jats:title>\n                    <jats:p>To generate reliable information on COPD management, outcomes, treatment patterns and adherence, and disease knowledge in China in a real-world setting.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A 52-week multicentre, prospective, observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Outpatients (\u2a7e40\u2009years old) diagnosed with COPD were enrolled from 50 secondary and tertiary hospitals across six geographical regions. Data were collected in routine clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Between June 2017 and January 2019, 5013 patients were enrolled and 4978 included in the analysis. Mean [standard deviation (SD)] age was 66.2 (8.9) years, 79.5% were male and 90% had moderate-to-very-severe airflow limitation. Annual rates of overall and severe exacerbation were 0.56 and 0.31, respectively. During 1\u2009year, 1536 (30.8%) patients experienced \u2a7e1 exacerbation and 960 (19.3%) patients had \u2a7e1 exacerbation requiring hospitalization\/emergency visit. Mean (SD) COPD assessment test score was 14.6 (7.6) at baseline and 10.6 (6.8) at follow-up; however, 42\u201355% of patients had persistent dyspnoea, chest tightness and wheezing at 1\u2009year. The most prescribed treatments were inhaled corticosteroid (ICS)\/long-acting \u03b22-agonist (LABA) (36.0%), ICS\/LABA\u2009+\u2009long-acting muscarinic antagonist (LAMA) (17.7%) and LAMA monotherapy (15.3%). Among patients with high exacerbation risk (GOLD Groups C and D), 10.1% and 13.1%, respectively, did not receive any long-acting inhalers; only 53.8% and 63.6% of Group C and D patients with \u2a7e1 exacerbation during follow-up were prescribed ICS-containing therapy, respectively. Mean (SD) adherence for long-acting inhalers was 59.0% (34.3%). Mean (SD) score for the COPD questionnaire was 6.7 (2.4).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>These results indicate a high burden of severe exacerbations and symptoms in Chinese outpatients with COPD, and low adherence with treatment guidelines, highlighting the need for more effective management nationwide.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Registration:<\/jats:title>\n                    <jats:p>The trial was registered on 20 March 2017 (ClinicalTrials.gov identifier: NCT03131362).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17534666231178692","type":"journal-article","created":{"date-parts":[[2023,6,15]],"date-time":"2023-06-15T07:48:25Z","timestamp":1686815305000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":11,"title":["REALizing and improving management of stable COPD in China: results of a multicentre, prospective, observational study (REAL)"],"prefix":"10.1177","volume":"17","author":[{"given":"Ting","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, National Clinical Research Centre for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China"},{"name":"Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Baiqiang","family":"Cai","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Peking Union Medical College Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bin","family":"Cao","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, National Clinical Research Centre for Respiratory Diseases, China-Japan Friendship Hospital, Beijing, China"},{"name":"Institute of Respiratory Medicine, Chinese Academy of Medical Science, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, The First Hospital of China Medical University, Shenyang, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuqiang","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yahong","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wenhua","family":"Jian","sequence":"additional","affiliation":[{"name":"State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Disease, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7857-5435","authenticated-orcid":false,"given":"Chen","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Pulmonary and Critical Care Medicine, National Clinical Research Centre for Respiratory Diseases, China-Japan Friendship Hospital, No. 2, East Yinghua Road, Chaoyang District, Beijing 100029, China"},{"name":"Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2023,6,15]]},"reference":[{"key":"bibr1-17534666231178692","first-page":"691","volume":"5","author":"GBD","year":"2015","journal-title":"Lancet Respir Med"},{"key":"bibr2-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(20)30105-3"},{"key":"bibr3-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31678-6"},{"key":"bibr4-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30841-9"},{"key":"bibr5-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00551-6"},{"key":"bibr6-17534666231178692","first-page":"260","volume":"6","author":"Duan RR","year":"2020","journal-title":"Chronic Dis Transl Med"},{"key":"bibr7-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31597-5"},{"key":"bibr8-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(18)30432-6"},{"key":"bibr9-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-019-8071-8"},{"key":"bibr10-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1016\/j.chest.2018.07.012"},{"key":"bibr11-17534666231178692","first-page":"255","volume":"36","author":"Chinese Medical Association of Respiratory Diseases Chronic Obstructive Pulmonary Disease Group","year":"2013","journal-title":"Chin J Tuberc Respir Dis"},{"key":"bibr12-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1186\/2001-1326-1-13"},{"key":"bibr13-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1136\/bmjresp-2017-000267"},{"key":"bibr14-17534666231178692","unstructured":"Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management and prevention of chronic obstructive pulmonary disease (2022 report), https:\/\/goldcopd.org\/wp-content\/uploads\/2021\/12\/GOLD-REPORT-2022-v1.1-22Nov2021_WMV.pdf (accessed 14 February 2022)."},{"key":"bibr15-17534666231178692","doi-asserted-by":"publisher","DOI":"10.21037\/jtd.2019.03.99"},{"key":"bibr16-17534666231178692","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S123896"},{"key":"bibr17-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-1393"},{"key":"bibr18-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200708-1290OC"},{"key":"bibr19-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00079409"},{"key":"bibr20-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(18)30103-6"},{"key":"bibr21-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1186\/s12890-019-1000-x"},{"key":"bibr22-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.201701-0218PP"},{"key":"bibr23-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1016\/j.pec.2009.11.020"},{"key":"bibr24-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1016\/j.arbres.2015.03.013"},{"key":"bibr25-17534666231178692","volume":"98","author":"Yang H","year":"2019","journal-title":"Medicine"},{"key":"bibr26-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1186\/s12931-022-02021-w"},{"key":"bibr27-17534666231178692","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S234042"},{"key":"bibr28-17534666231178692","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S146390"},{"key":"bibr29-17534666231178692","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S274024"},{"key":"bibr30-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(18)30200-5"},{"key":"bibr31-17534666231178692","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S40437"},{"key":"bibr32-17534666231178692","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S36997"},{"key":"bibr33-17534666231178692","doi-asserted-by":"publisher","DOI":"10.2147\/COPD.S161555"},{"key":"bibr34-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2014-006720"},{"key":"bibr35-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1378\/chest.14-2535"},{"key":"bibr36-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0909883"},{"key":"bibr37-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1186\/s12916-021-02000-w"},{"key":"bibr38-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1038\/s41533-020-00191-y"},{"key":"bibr39-17534666231178692","doi-asserted-by":"publisher","DOI":"10.1186\/1465-9921-14-109"}],"container-title":["Therapeutic Advances in Respiratory Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17534666231178692","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17534666231178692","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17534666231178692","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,2]],"date-time":"2025-03-02T05:59:27Z","timestamp":1740895167000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17534666231178692"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,1]]},"references-count":39,"alternative-id":["10.1177\/17534666231178692"],"URL":"https:\/\/doi.org\/10.1177\/17534666231178692","relation":{"has-review":[{"id-type":"doi","id":"10.1177\/17534666231178692\/v1\/decision1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666231178692\/v1\/review4","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666231178692\/v1\/review3","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666231178692\/v1\/review2","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666231178692\/v1\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666231178692\/v2\/review1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666231178692\/v2\/response1","asserted-by":"object"},{"id-type":"doi","id":"10.1177\/17534666231178692\/v2\/decision1","asserted-by":"object"}]},"ISSN":["1753-4666","1753-4666"],"issn-type":[{"value":"1753-4666","type":"print"},{"value":"1753-4666","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,1]]},"article-number":"17534666231178692"}}