As the holidays approach, COPD patients face an increased risk of exacerbations due to seasonal stress and winter illnesses. In his recent Virtual Hallway lecture, respirologist Dr. Pierre Landry shared strategies for preventing these flares and optimizing treatment, including the advantages of single inhaler triple therapy (SITT). Here’s a quick dive into his clinical insights.

Why Exacerbations Matter

Each COPD exacerbation causes a loss of lung function, pushing patients further from their baseline. Older adults often fare worse, with hospital stays leading to rapid deconditioning. Avoiding these exacerbations isn’t just about lung health—it’s about preserving quality of life.

First-Line Defense: Lifestyle Changes and Rehabilitation

For prevention, nothing tops smoking cessation. Dr. Landry recommends a mix of pharmacologic aids, such as nicotine replacement and varenicline, to support patients ready to quit. He also emphasizes the benefits of pulmonary rehabilitation, though access remains limited.

SITT: Simplicity in COPD Care

Single inhaler triple therapy (SITT) combines a LAMA, LABA, and ICS in one device. SITT’s simplicity increases patient adherence and reduces exacerbations by up to 33% compared to multiple inhalers. Dr. Landry is clear: for patients struggling with adherence or facing frequent exacerbations, SITT can simplify management and improve outcomes.

Essential Vaccinations for COPD Patients

Vaccinations are another key. Dr. Landry advocates annual flu and COVID-19 shots, as well as pneumococcal and RSV vaccines, to guard against infections that worsen COPD. Prevention here means fewer exacerbations and safer winters.

For the Tough Cases: Oral Therapies

When inhaled therapies fall short, Dr. Landry turns to oral treatments like azithromycin and N-acetylcysteine (NAC) to control inflammation and mucus. These additions, especially in non-smokers, can make a critical difference for those with chronic bronchitis symptoms.

Biologics on the Horizon

While still in clinical trials for COPD in Canada, biologics like dupilumab could soon offer new options for patients with an eosinophilic phenotype. Until then, Dr. Landry advises focusing on proven treatments.

The Takeaway

Dr. Landry’s approach to COPD management focuses on strong adherence, preventive care, and comprehensive treatment, all designed to keep patients out of hospitals and living fuller lives. Single inhaler triple therapy, combined with vaccinations and lifestyle support, can be a straightforward yet powerful approach.

Catch the full recording on the Virtual Hallway platform to get all of Dr. Landry’s practical tips on COPD management.

Disclaimer: This post shares educational insights and does not replace personalized medical advice.

As we enter flu season, it's crucial to be prepared for the increased risk of COPD exacerbations in our patients. Dr. Landry, in his webinar on "Preventive Care in COPD," emphasizes that viral infections are one of the most common triggers for these exacerbations, making this a particularly important topic during flu season12.

The webinar, "Preventive Care in COPD: The Role of Vaccination in Reducing Exacerbations During Flu Season," emphasizes a multifaceted approach to managing COPD, going beyond just addressing symptoms.

Here's a summary of key takeaways:

  • The Urgency of COPD Exacerbation Prevention: Dr. Landry underscores the seriousness of COPD exacerbations, reminding us that 20-40% of patients die within a year of their first exacerbation3. This statistic highlights the critical need for proactive management to prevent these events.
  • Triple Inhaled Therapy: A Cornerstone of COPD Management: The 2023 COPD Treatment Guidelines, as explained by Dr. Landry, recommend triple inhaled therapy as a mainstay for patients with moderate to severe COPD456. This approach combines a long-acting antimuscarinic (LAMA), a long-acting beta-agonist (LABA), and an inhaled corticosteroid (ICS) to effectively manage symptoms and reduce exacerbations4. Dr. Landry further points out that single-inhaler triple therapy is preferable as it has been shown to improve patient adherence and lead to better outcomes467.
  • Vaccinations: A Powerful Tool for COPD Patients: Dr. Landry strongly advocates for vaccinations as a critical component of COPD management, especially during flu season8. He emphasizes that while inhaled therapy is essential, vaccinations offer an additional layer of protection against exacerbations, which are often triggered by respiratory infections like the flu.

Influenza Vaccination: Dr. Landry recommends annual influenza vaccination for all COPD patients. He suggests the high-dose vaccine for eligible patients as it elicits a stronger immune response, which is especially important for older adults who may have weaker immune systems9.

Pneumococcal Vaccination: Given the potential for pneumococcal infections to trigger exacerbations, Dr. Landry recommends pneumococcal vaccination with both the PCV15 or PCV20 followed by the PCV23 for optimal protection.

COVID-19 Vaccination: Dr. Landry advises healthcare professionals to stay informed about the latest COVID-19 vaccination guidelines, as these recommendations can change based on the circulating variants and guidance from public health authorities.

RSV Vaccination: Dr. Landry highlights the underappreciated burden of RSV infection in older adults, with a 1 in 9 chance of death for those hospitalized. He strongly recommends the RSV vaccine, particularly for patients over 60, as studies show it is safe and effective in preventing severe RSV infections, a significant risk factor for exacerbations.

By embracing a comprehensive approach that includes both pharmacological interventions like triple inhaled therapy and preventive measures like vaccination, healthcare professionals can make a significant difference in the lives of their COPD patients, particularly during the challenging flu season.

Remember, the webinar recording is available for free on the Virtual Hallways platform. Don't miss this opportunity to enhance your understanding of COPD management and access practical tools to improve patient care!

Disclaimer: This lecture is for educational purposes only and does not replace medical advice or treatment plans tailored to individual patients."

Virtual Hallway recently hosted a highly anticipated session led by Dr. Celia Robichaud, a child and adolescent psychiatrist, focused on the challenges of managing Attention Deficit Hyperactivity Disorder (ADHD) in primary care settings. Dr. Robichaud shared expert strategies for identifying, diagnosing, and managing ADHD, from youth to adulthood, while addressing the complexities of comorbid conditions and the impact of social media on ADHD awareness.

Key Takeaways:

Accurate ADHD Diagnosis in Primary Care:

  • Diagnosis should not be based solely on self-report, especially when influenced by social media content. Screening tools such as the Adult ADHD Self-Report Scale (ASRS) or SNAP-IV should complement clinical assessments.
  • Collateral information, especially from childhood, is critical since ADHD symptoms must have been present before age 12.

ADHD and Comorbid Conditions:

  • Dr. Robichaud emphasized the frequent overlap between ADHD and conditions like anxiety and depression. Misdiagnosis is common when relying on self-reported symptoms without proper clinical evaluation.
  • Social media has heightened awareness but also contributed to misinformation, with up to 52% of TikTok content on ADHD deemed misleading.

Medication Management:

  • Long-acting stimulants remain the first-line treatment for ADHD. Dr. Robichaud reviewed the differences between methylphenidate-based and amphetamine-based stimulants, noting that while both are effective, amphetamines may be more potent but also less tolerated.
  • Non-stimulant options like atomoxetine and guanfacine offer alternatives, especially for patients with anxiety or those unable to tolerate stimulants.

Importance of Non-Pharmacological Strategies:

  • Exercise and structured environments play crucial roles in managing ADHD symptoms. Physical activity enhances executive function and improves motor skills, while clear routines and expectations help foster success in both academic and personal settings.

The Role of Trauma:

  • Trauma can mimic ADHD symptoms, making it important to distinguish between the two. In cases of trauma, medications like guanfacine may help with hyperarousal, but trauma-specific interventions are crucial for effective treatment.

Q&A Highlights: During the Q&A, participants discussed the role of diet, specifically high sugar intake, in ADHD management. Dr. Robichaud stressed the importance of balanced nutrition, while noting that no specific diet cures ADHD. The conversation also touched on the rising trend of adult ADHD diagnosis and the need for careful assessment beyond self-reported symptoms.


Missed the Lecture? Catch the full session on-demand and earn your MainPro+ credits here. Learn from Dr. Robichaud’s comprehensive approach to ADHD diagnosis and treatment, and enhance your practice with the latest insights.


Disclaimer: This lecture is for educational purposes only and does not replace medical advice or treatment plans tailored to individual patients."

Virtual Hallway recently hosted a dynamic webinar to kick off the academic year, focusing on simplifying Chronic Kidney Disease (CKD) management in patients with type 2 diabetes. Led by nephrologist Dr. David Cherney and moderated by Dr. Jacob Cookey, the session reviewed new strategies for improving patient outcomes.

The webinar spotlighted the FLOW study, which examined how innovative diabetes treatments can prevent kidney-related complications. Dr. Cherney emphasized the study’s findings, showing how early intervention with SGLT2 inhibitors can slow CKD progression and improve patient quality of life.

Key Takeaways:

FLOW Study Insights: SGLT2 inhibitors not only manage diabetes but also offer substantial kidney protection, delaying advanced CKD.

Proactive Management: Early detection and intervention, based on FLOW data, lead to better patient outcomes and reduced need for invasive treatments.

Personalized Care: Treatment must be tailored, considering individual kidney function and diabetes control.

Collaborative Approach: A multidisciplinary team of specialists and primary care providers is crucial for effective CKD management.

Highlights from the Q&A

During the Q&A, participants asked about real-world application. When addressing concerns over SGLT2 inhibitor side effects or costs, Dr. Cherney stressed the importance of patient education and alternative access options. He also noted the significant role diet plays in CKD management, advising small, patient-friendly dietary adjustments in collaboration with dietitians.

Missed it?

Watch the full session on-demand, learn how the FLOW study is reshaping CKD and diabetes care and claim your MainPro+ credit.

Disclaimer: The lecture and all related materials are provided for educational purposes only and do not constitute medical advice. They are not intended to be used as a substitute for professional medical judgment, diagnosis, or treatment. Always consult a qualified healthcare provider for advice regarding any medical condition or treatment.

physician watching continuing education lecture on virtual hallway

In the rapidly evolving field of healthcare, Continuing Medical Education (CME) remains a cornerstone for professionals aiming to enhance their knowledge and skills. Virtual Hallway offers a suite of CME events designed to meet your learning needs. Here’s how you can maximize the value of these offerings:

1. Watch It Live

The best way to immerse yourself in our CME events is by attending live. Register early, mark your calendar, and join the event to not only absorb real-time insights but also feel the pulse of contemporary medical discussions. Live participation brings the unique advantage of immediacy – you're learning in the moment, alongside peers who are equally eager to expand their horizons.

2. Engage in the Discussion

Our live sessions thrive on interaction, featuring active Q&A segments with over 30 questions typically asked and answered. This is your chance to probe deeper into subjects, clarify doubts, or explore new perspectives. If you have a burning question, don’t wait! Submit it beforehand when you register to ensure it gets the attention it deserves. Engaging actively not only enriches your learning experience but also contributes to the collective knowledge of the community.

3. Watch On-Demand

Can't make it to a live event? No problem. Virtual Hallway boasts an extensive backlist of over 20 lectures available on-demand. This flexibility allows you to tailor your learning journey according to your schedule, ensuring you never miss out on valuable insights. Whether it’s a deep dive into a specialized topic or a broad overview of emerging trends, our on-demand library has you covered.

4. Claim Your Credits

Continuing your education is rewarding in more ways than one. With Virtual Hallway, you can claim your credits for MAINPRO in Canada or the equivalent in the U.S. after participating in our CME events. This ensures that your professional development is recognized, keeping you compliant with accreditation requirements and at the top of your game.

5. Listen on the Go

Our mobile app revolutionizes how and where you can engage with CME content. Whether you're commuting, exercising, or between appointments, you can listen to or watch our lectures wherever you go. This convenience means that your learning never has to pause, integrating seamlessly with your busy lifestyle.

Virtual Hallway's CME events are more than just lectures; they're gateways to advanced practice and heightened patient care. By attending live, engaging in discussions, utilizing our on-demand resources, claiming your credits, and leveraging our mobile app, you ensure that your educational journey is rich, rewarding, and uninterrupted. Dive into our CME offerings today and take a significant step toward your professional excellence.

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