Department of Pneumology and Internal Intensive Care Medicine, University Hospital RWTH Aachen, Aachen, Germany.
Institute of Clinical Pharmacology, University Hospital RWTH Aachen, Aachen, Germany.
Int J Chron Obstruct Pulmon Dis. 2022 Aug 11;17:1827-1834. doi: 10.2147/COPD.S367062. eCollection 2022.
Dyspnea is a leading symptom of COPD that causes presentations in emergency departments or negatively impacts on them. Guideline-based inhalation therapies are intended to reduce dyspnea in COPD patients. This study analyzed how common guideline recommended inhalation therapy regimens are occurring in clinical practice among COPD patients presenting to emergency departments due to adverse drug reactions in polytherapy using data of the German ADRED database.
In total, 269 COPD cases were identified. In a further analysis, all cases were analyzed for documented GOLD stage and guideline-recommended inhalation therapy for COPD. Dyspnea and other symptoms identified during ED presentation were analyzed and compared between patients who did and did not receive the guideline's recommended inhalation therapy.
In this observation, 41% (n = 46) of all 112 cases with a documented COPD and GOLD stage received an underdosed therapy according to current guidelines. Dyspnea was the most common identified symptom (32%, n = 36) in this cohort and occurred more often in patients who received an underdosage of inhalation therapy (p < 0.01).
Patients with COPD presenting to ED with ADRs show a high rate of non-guideline-recommended inhalation therapy and present more often with dyspnea compared to those COPD patients who received an adequate dosing of inhalation therapy.
呼吸困难是 COPD 的主要症状之一,可导致患者到急诊科就诊或对其产生负面影响。基于指南的吸入疗法旨在减轻 COPD 患者的呼吸困难。本研究通过使用德国 ADRED 数据库的数据,分析了在多药治疗中因药物不良反应而到急诊科就诊的 COPD 患者中,常见的基于指南的吸入治疗方案在临床实践中的应用情况。
共确定了 269 例 COPD 病例。在进一步的分析中,所有病例均根据 GOLD 分期和 COPD 指南推荐的吸入疗法进行分析。对急诊科就诊时出现的呼吸困难和其他症状进行分析,并比较接受和未接受指南推荐吸入疗法的患者之间的差异。
在本观察中,112 例有记录的 COPD 和 GOLD 分期的患者中,有 41%(n=46)接受了低于当前指南建议剂量的治疗。呼吸困难是该队列中最常见的症状(32%,n=36),且在接受吸入治疗剂量不足的患者中更为常见(p<0.01)。
因不良反应到急诊科就诊的 COPD 患者接受的非指南推荐的吸入治疗率较高,与接受足够剂量吸入治疗的 COPD 患者相比,呼吸困难更为常见。