General Practitioners Research Institute, Groningen, The Netherlands.
Observational and Pragmatic Research Institute, Singapore, Singapore.
NPJ Prim Care Respir Med. 2023 May 3;33(1):18. doi: 10.1038/s41533-023-00334-x.
This study aims to understand healthcare professionals' thoughts and motivations about optimal management and treatment of patients with chronic obstructive pulmonary disease (COPD). We conducted a DELPHI survey through an online questionnaire distributed to 220 panellists from six European countries and a discrete choice experiment to describe the relationship between selected clinical criteria and the initial COPD treatment of choice. One hundred twenty-seven panellists (general practitioners [GPs] and pulmonologists) completed the survey. Despite the familiarity and use (89.8%) of the GOLD classification for initial treatment selection, a frequent use of LAMA/LABA/ICS was noted. In fact, panellists agreed that inhaled corticosteroids (ICS) are over-prescribed in the primary care setting. Our study showed that GPs felt less confident than pulmonologists with ICS withdrawal. This mismatch observed between best practice and behaviour indicates the need to increase awareness and efforts to improve the adherence to guidelines in clinical practice.
本研究旨在了解医疗保健专业人员在慢性阻塞性肺疾病（COPD）患者的最佳管理和治疗方面的想法和动机。我们通过在线问卷向来自六个欧洲国家的 220 名小组成员进行了 DELPHI 调查，并进行了离散选择实验，以描述选定的临床标准与初始 COPD 治疗选择之间的关系。127 名小组成员（全科医生[GP]和肺科医生）完成了调查。尽管对 GOLD 分类用于初始治疗选择的熟悉程度和使用率（89.8%）很高，但 LAMA/LABA/ICS 的使用频率也很高。事实上，小组成员一致认为皮质类固醇（ICS）在初级保健环境中被过度开具。我们的研究表明，与肺科医生相比，全科医生对 ICS 停药的信心较低。这种最佳实践与行为之间的不匹配表明，需要提高认识并努力改善临床实践中对指南的遵循。
