Minas M, Dimitropoulos K, Pastaka Ch, Papadopoulos D, Markoulis N, Gourgoulianis K I
Pulmonary Department, Medical School, University of Thessaly, Greece.
Prev Med. 2005 Mar;40(3):274-7. doi: 10.1016/j.ypmed.2004.06.010.
The purpose of this study was to assess the agreement of asthma and chronic obstructive pulmonary disease (COPD) treatment prescribed by physicians and pulmonologists in comparison to asthma and COPD guidelines and the need of the implementation of COPD guidelines in primary health care physicians.
Eighty-three asthma patients and 100 COPD patients were chosen and classified in relation to the agreement of their treatment prescribed by a health care physician and that mentioned by global initiative for chronic obstructive lung disease (GOLD) The COPD patients were classified according to their stage of the disease too.
Both pulmonologists and primary health care physicians manage asthma patients following asthma guidelines, while great proportion of COPD patients are undertreated by primary health care physicians. The proportion of undertreated COPD patients is decreased as the stage of disease is progressing.
COPD patients mainly are undertreated by primary health care physicians when they are in the primary stages of the disease. The overtreatment of some patients consists of high doses of inhaled steroids prescribed by both pulmonologists, and mainly, primary health care physicians. Therefore, it can be concluded that there is the need of the implementation of COPD guideline by primary health care physicians and the need of COPD patients to be diagnosed in early stages by performing spirometry.
本研究旨在评估内科医生和肺科医生所开具的哮喘及慢性阻塞性肺疾病（COPD）治疗方案与哮喘和COPD指南的一致性，以及基层医疗医生实施COPD指南的必要性。
选取83例哮喘患者和100例COPD患者，根据基层医疗医生所开具的治疗方案与慢性阻塞性肺疾病全球倡议组织（GOLD）所提及方案的一致性进行分类。COPD患者也根据其疾病阶段进行分类。
肺科医生和基层医疗医生均按照哮喘指南对哮喘患者进行治疗，而很大一部分COPD患者未得到基层医疗医生的充分治疗。随着疾病阶段的进展，未得到充分治疗的COPD患者比例降低。
COPD患者在疾病初期主要未得到基层医疗医生的充分治疗。部分患者的过度治疗表现为肺科医生，主要是基层医疗医生开具高剂量吸入性类固醇药物。因此，可以得出结论，基层医疗医生有必要实施COPD指南，且有必要通过肺功能测定对COPD患者进行早期诊断。
