Turan Onur, Emre Julide Celdir, Deniz Sami, Baysak Aysegul, Turan Pakize Ayse, Mirici Arzu
a Chest Diseases Department , Gelibolu State Hospital , Canakkale , Turkey.
b Chest Diseases Department , Turgutlu State Hospital , Manisa , Turkey.
Expert Opin Pharmacother. 2016;17(2):153-8. doi: 10.1517/14656566.2016.1115482. Epub 2015 Dec 2.
INTRODUCTION-OBJECTIVE: Despite the availability of national and international guidelines, chronic obstructive pulmonary diseases (COPD) treatment is not always prescribed according to these recommendations. We aimed to see if COPD patients in Turkey have been treated appropriately according to COPD guidelines.
This is a cross-sectional study carried out in six different chest diseases clinics. The COPD outpatients were categorized by spirometry classification (SC) and the combined classification (CC) of COPD. The treatment protocols were evaluated to check whether they were suitable for both classifications.
Overall, 307 patients were included in the study. Of the treatment protocols, 40.4% were suitable for both classifications: 30.9% for CC and 20.8% for SC. A total of 51.8% of the patients were reported to be using an unsuitable therapy for SC and 38.4% for CC. Ninety-eight per cent of the unsuitable treatment was overtreatment. Fifty-eight per cent of the patients were using LABA + LAMA + ICS. Improper ICS usage was identified in 97.1% in CC, 93.1% in SC. The cost savings of all patients in one year would be 17,099$ with an appropriate treatment protocol following COPD guidelines.
The most common type of inappropriate COPD treatments is overtreatment, generally with ICS. As treatment protocols following COPD guidelines change over time, there is still a low rate of adherence by clinicians in their clinical practice to guideline recommendations. Awareness of these guidelines by pulmonary specialists should be improved.
引言 - 目的:尽管有国家和国际指南,但慢性阻塞性肺疾病(COPD)的治疗并不总是按照这些建议进行。我们旨在了解土耳其的COPD患者是否根据COPD指南得到了适当的治疗。
这是一项在六个不同的胸部疾病诊所进行的横断面研究。COPD门诊患者根据肺功能测定分类(SC)和COPD综合分类(CC)进行分类。评估治疗方案以检查它们是否适用于这两种分类。
总体而言,307名患者纳入了研究。在治疗方案中,40.4%适用于两种分类:30.9%适用于CC,20.8%适用于SC。据报告,共有51.8%的患者使用了不适用于SC的治疗方法,38.4%的患者使用了不适用于CC的治疗方法。98%的不适当治疗是过度治疗。58%的患者使用LABA + LAMA + ICS。在CC中,97.1%的患者存在ICS使用不当,在SC中为93.1%。遵循COPD指南采用适当的治疗方案,所有患者一年可节省成本17,099美元。
COPD最常见的不适当治疗类型是过度治疗,通常使用ICS。随着遵循COPD指南的治疗方案随时间变化,临床医生在临床实践中对指南建议的依从率仍然很低。应提高肺部专家对这些指南的认识。