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法国急性 COPD 加重期的管理:私人诊所环境下的定性调查。

Management of acute COPD exacerbations in France: A qualitative survey in a private practice setting.

机构信息

Medical Department, GlaxoSmithKline, Rueil-Malmaison, France.

Association de réflexion sur le Parcours de Soins en milieu Respiratoire, La Rochelle, France.

出版信息

PLoS One. 2021 Jan 22;16(1):e0245373. doi: 10.1371/journal.pone.0245373. eCollection 2021.

Abstract

BACKGROUND

The current prevalence of chronic obstructive pulmonary disease (COPD) in France is estimated to be 2.6 million and is predicted to increase to 2.8 million by 2025. Presently, there is a lack of data on COPD management within the private healthcare setting. The aim of this study was to investigate the management of COPD exacerbations by pulmonologists within private practices in France.

METHODS

A prospective, online, qualitative survey was distributed to private practice pulmonologists in France. The survey covered all aspects of COPD management from diagnosis and therapeutic management, to secondary prevention and organization of care. Survey responses were collected between 27 January 2018 and 18 June 2018 and all data were summarized descriptively.

RESULTS

The survey had a response rate of 20.6%, with 116 out of 563 pulmonologists providing responses. Overall, 87.4% of respondents stated that the management of COPD represented over 15% of their total clinical activity. Most respondents indicated that they work closely with general practitioners and a large multidisciplinary team to manage patients with numerous comorbidities. Following a COPD exacerbation, the majority of respondents (78.4%) were in favor of using respiratory-connected devices (class 2a-connected medical device according to the French HAS classification and available on medical prescription) to assist with patient follow-up at home.

CONCLUSIONS

COPD management forms part of the core clinical activity for pulmonologists within the private practice setting in France. Patients with COPD generally have multiple comorbidities and are managed by a multidisciplinary team in line with French guidelines. The use of respiratory-connected devices was highlighted as an important new strategy for improving patient care following a COPD exacerbation.

摘要

背景

目前,法国慢性阻塞性肺疾病(COPD)的患病率估计为 260 万,预计到 2025 年将增加到 280 万。目前,私人医疗保健环境中缺乏 COPD 管理数据。本研究旨在调查法国私人诊所的肺病专家对 COPD 加重的管理情况。

方法

一项前瞻性、在线、定性调查分发给法国私人执业的肺病专家。该调查涵盖了 COPD 管理的各个方面,从诊断和治疗管理到二级预防和护理组织。调查答复于 2018 年 1 月 27 日至 2018 年 6 月 18 日期间收集,所有数据均以描述性方式进行总结。

结果

调查的回复率为 20.6%,563 名肺病专家中有 116 名提供了回复。总体而言,87.4%的受访者表示 COPD 的管理占其总临床活动的 15%以上。大多数受访者表示,他们与全科医生和一个大型多学科团队密切合作,共同管理患有多种合并症的患者。在 COPD 加重后,大多数受访者(78.4%)赞成使用呼吸相关设备(根据法国 HAS 分类为 2a 级连接医疗器械,可通过医疗处方获得)来协助患者在家中进行后续治疗。

结论

COPD 管理是法国私人诊所肺病专家核心临床活动的一部分。COPD 患者通常有多种合并症,并且根据法国指南由多学科团队进行管理。呼吸相关设备的使用被强调为改善 COPD 加重后患者护理的一项重要新策略。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/630e/7822540/4f2be78720ea/pone.0245373.g001.jpg

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