College of Medicine and Public Health, Flinders University, Adelaide, South Australia, Australia.
College of Health and Human Sciences, Charles Darwin University, Darwin, Northern Territory, Australia.
BMJ Open Respir Res. 2022 Aug;9(1). doi: 10.1136/bmjresp-2022-001295.
The prevalence of chronic obstructive pulmonary disease (COPD) is higher among Indigenous Australians than that of non-Indigenous Australians. However, no studies have investigated COPD disease awareness and knowledge among Indigenous Australians. In this study, we assessed the COPD disease awareness among Indigenous and non-Indigenous patients in the Top End Health Service region of the Northern Territory of Australia.
Of a total convenience sample of 100 adults, 86 patients consented to participate in this study over a 15-month period. A structured interview was conducted to identify participant's level of knowledge about COPD, medications, self-management, healthcare interaction and utilisations.
Most (69%) participants were Indigenous and men (52%). Indigenous patients were significantly younger (mean 56 vs 68 years p<0.001), with a higher proportion of remote residence and current smoking. COPD knowledge across the cohort was low, with 68% of Indigenous and 19% of non-Indigenous participants reporting they 'know nothing/had never heard of COPD'. Most patients self-reported use of puffers/inhalers and were able to identify medication used; however, adherence to therapy was observed in only 18%. Shortness of breath was the most common symptom for hospital presentation (83%) and 69% of Indigenous patients reported seeking medical attention during an exacerbation. Self-management and COPD action plans were poorly implemented. A significant proportion (49%) reported ≥2 hospital admissions in the preceding 12 months. During exacerbation, although the majority of Indigenous patients were transferred to a tertiary centre from remote communities, patient's preference was to be managed in their respective local communities.
Awareness and understanding of COPD are low in this cohort on several domains. Tailored and culturally appropriate initiatives for both patients and health professionals alike are required to improve COPD disease management among Indigenous population. This will not only improve quality of life but also reduce recurrent hospitalisation, healthcare cost and utilisation.
慢性阻塞性肺疾病（COPD）在澳大利亚原住民中的发病率高于非原住民。然而，目前还没有研究调查过澳大利亚原住民对 COPD 的认知程度。在这项研究中，我们评估了澳大利亚北部地区北部地区顶端健康服务区域内的土著和非土著患者的 COPD 疾病认知程度。
在总共方便的 100 名成年人中，有 86 名患者在 15 个月的时间内同意参加这项研究。进行了结构化访谈，以确定参与者对 COPD、药物、自我管理、医疗保健互动和利用的了解程度。
大多数（69%）参与者是原住民，男性（52%）。原住民患者明显更年轻（平均 56 岁 vs 68 岁，p<0.001），居住在偏远地区和目前吸烟的比例更高。整个队列的 COPD 知识水平较低，68%的原住民和 19%的非原住民参与者表示他们“一无所知/从未听说过 COPD”。大多数患者自我报告使用吸入器/吸入器，并能够识别使用的药物；然而，只有 18%的患者坚持用药。呼吸困难是最常见的住院症状（83%），69%的原住民患者在病情加重时表示曾寻求医疗救助。自我管理和 COPD 行动计划实施情况不佳。有相当一部分（49%）患者在过去 12 个月内报告至少有 2 次住院。在病情加重期间，尽管大多数原住民患者从偏远社区转至三级中心，但患者更倾向于在各自的当地社区接受治疗。
在多个方面，该队列对 COPD 的认识和理解程度都较低。需要针对患者和卫生专业人员制定有针对性且文化上适宜的计划，以改善原住民人群的 COPD 疾病管理。这不仅将提高生活质量，还将减少反复住院、医疗保健成本和利用。
