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慢性阻塞性肺疾病急性加重期后的全科医疗护理:澳大利亚全科医生调查。

General practice care following acute exacerbations of COPD: A survey of Australian general practitioners.

机构信息

Monash University, School of Primary and Allied Health Care, Frankston, VIC, Australia.

Monash University, School of Public Health and Preventive Medicine, Frankston, VIC, Australia.

出版信息

PLoS One. 2023 Apr 25;18(4):e0284731. doi: 10.1371/journal.pone.0284731. eCollection 2023.

Abstract

Acute exacerbations of COPD (AECOPDs) are one of the leading causes of preventable hospital admissions in Australia. Exacerbations are the strongest predictor for future exacerbations. The period immediately following an exacerbation is a high-risk period for recurrence and critical time to intervene. The aim of this study was to identify current general practice care for patients following an AECOPD in Australia and gain insights into knowledge of evidence-based care. A cross-sectional survey was created and disseminated electronically to Australian general practitioners (GPs). Data were analysed descriptively. Comparisons between groups were made using Chi squared tests. From 64 responses, 47% were familiar with the COPD-X Plan. Only 50% described reviewing patients within seven days of discharge mostly related to a lack of awareness of the hospital admission. 50% of surveyed GPs reported hospital discharge summaries did not provide the information they required. Smoking, immunisation and medications were regularly assessed by >90% respondents at follow-up visits, while referrals to pulmonary rehabilitation, and evaluation of spirometry and oxygen therapy were not prioritised. GPs appear to require support to increase their familiarity with COPD guidelines and inform evidence-based clinical practice. The handover/communication process from hospital to primary care appears an important area for future improvement.

摘要

COPD(慢性阻塞性肺疾病)急性加重(AECOPDs)是澳大利亚可预防住院的主要原因之一。加重是未来加重的最强预测因素。加重后立即是复发的高风险期,也是干预的关键时期。本研究旨在确定澳大利亚 AECOPD 患者的当前一般实践护理,并深入了解循证护理知识。创建了一个横断面调查,并通过电子方式分发给澳大利亚全科医生(GP)。对数据进行描述性分析。使用卡方检验比较组间差异。在 64 份回复中,47%的人熟悉 COPD-X 计划。只有 50%的人描述了在出院后七天内对患者进行复查,这主要是因为他们缺乏对住院的认识。50%的接受调查的全科医生报告说,他们需要的信息没有在出院小结中提供。在随访时,超过 90%的受访者定期评估吸烟、免疫接种和药物使用情况,而向肺康复、肺功能和氧疗评估的转诊并没有得到优先考虑。全科医生似乎需要支持来提高他们对 COPD 指南的熟悉程度,并告知循证临床实践。从医院到初级保健的交接/沟通过程似乎是未来需要改进的一个重要领域。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ab16/10129000/a3cab2d43143/pone.0284731.g001.jpg

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