Treatment of chronic obstructive pulmonary disease in hospitalized geriatric patients.

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is frequent in older subjects due to deterioration of pulmonary function and lifelong exposure to risk factors. Furthermore, COPD is often underreported because of the gradual onset of symptoms and reduced perception of symptoms in the elderly. There is thus a risk of undertreatment of COPD in older subjects.

METHODS

We retrospectively analyzed dossiers of 229 hospitalized geriatric patients with COPD, complete assessment datasets and successful lung function tests.

RESULTS

The sample comprised 78 men (38 %; mean age 77 ± 7 years) and 151 women (66 %; mean age 81 ± 6 years). The number of untreated patients decreased from 68 (28 %) at admission to 35 (14 %) at discharge (p < 0.01). Absence of treatment was associated with severity of disease: mild COPD was less likely to be treated. During the hospital stay, the prescription of metered dose inhalers (MDIs) decreased and the prescription of nebulizers increased, most likely due to the coordination problems associated with using inhalers.

CONCLUSION

Undertreatment of COPD is frequent among hospitalized geriatric patients. There is a need for adaption of current guidelines to the needs of older patients with frailty or cognitive impairment.