School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.
Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden.
Int J Chron Obstruct Pulmon Dis. 2024 May 15;19:1069-1077. doi: 10.2147/COPD.S455080. eCollection 2024.
Patient education in chronic obstructive pulmonary disease (COPD) is recommended in treatment strategy documents, since it can improve the ability to cope with the disease. Our aim was to identify the extent of and factors associated with patient education in patients with COPD in a primary health care setting.
In this nationwide study, we identified 29,692 COPD patients with a registration in the Swedish National Airway Register (SNAR) in 2019. Data on patient education and other clinical variables of interest were collected from SNAR. The database was linked to additional national registers to obtain data about pharmacological treatment, exacerbations and educational level.
Patient education had been received by 44% of COPD patients, 72% of whom had received education on pharmacological treatment including inhalation technique. A higher proportion of patients who had received education were offered smoking cessation support, had performed spirometry and answered the COPD Assessment Test (CAT), compared with patients without patient education. In the adjusted analysis, GOLD grade 2 (OR 1.29, 95% CI 1.18-1.42), grade 3 (OR 1.41, 95% CI 1.27-1.57) and grade 4 (OR 1.79, 95% CI 1.48-2.15), as well as GOLD group E (OR 1.17, 95% CI 1.06-1.29), ex-smoking (OR 1.70, 95% CI 1.56-1.84) and current smoking (OR 1.45, 95% CI 1.33-1.58) were positively associated with having received patient education, while cardiovascular disease (OR 0.92, 95% CI 0.87-0.98) and diabetes (OR 0.93, 95% CI 0.87-1.00) were negatively associated with receipt of patient education.
Fewer than half of the patients had received patient education, and the education had mostly been given to those with more severe COPD, ex- and current smokers and patients with fewer comorbidities. Our study highlights the need to enhance patient education at an earlier stage of the disease.
在慢性阻塞性肺疾病（COPD）的治疗策略文件中推荐对患者进行教育，因为这可以提高患者应对疾病的能力。我们的目的是在初级保健环境中确定 COPD 患者接受患者教育的程度和相关因素。
在这项全国性研究中，我们确定了 2019 年在瑞典国家气道登记处（SNAR）登记的 29692 名 COPD 患者。从 SNAR 中收集了有关患者教育和其他感兴趣的临床变量的数据。该数据库与其他国家登记处链接，以获取关于药物治疗、加重和教育程度的数据。
44%的 COPD 患者接受了患者教育，其中 72%接受了药物治疗（包括吸入技术）教育。与未接受患者教育的患者相比，接受过教育的患者更有可能获得戒烟支持、进行肺功能检查和回答 COPD 评估测试（CAT）。在调整后的分析中，GOLD 分级 2（OR 1.29，95%CI 1.18-1.42）、3 级（OR 1.41，95%CI 1.27-1.57）和 4 级（OR 1.79，95%CI 1.48-2.15），以及 GOLD 组 E（OR 1.17，95%CI 1.06-1.29）、已戒烟（OR 1.70，95%CI 1.56-1.84）和当前吸烟者（OR 1.45，95%CI 1.33-1.58）与接受患者教育呈正相关，而心血管疾病（OR 0.92，95%CI 0.87-0.98）和糖尿病（OR 0.93，95%CI 0.87-1.00）与接受患者教育呈负相关。
不到一半的患者接受了患者教育，而且教育主要针对那些 COPD 更严重、曾经和现在吸烟以及合并症较少的患者。我们的研究强调了在疾病早期阶段加强患者教育的必要性。
