Du Dongru, Hu Xueru, Zuo Qiunan, Xu Dan, Zhu Tao, Fan Tao, Yang Jiao, Xu Weiguo, Wei Hailong, Baima Kangzhuo, Zhang Ying, Gu Yanhui, Chen Lei, Luo Fengming, Shen Yongchun, Wen Fuqiang
Department of Pulmonary and Critical Care Medicine, West China Hospital, Sichuan University, Chengdu, 610041, China.
State Key Laboratory of Respiratory Health and Multimorbidity, West China Hospital, Sichuan University, Chengdu, 610041, China.
NPJ Prim Care Respir Med. 2025 Jan 25;35(1):6. doi: 10.1038/s41533-025-00413-1.
This survey aimed to investigate the availability of drugs for stable chronic obstructive pulmonary disease (COPD) treatment in Chinese hospitals and to determine whether drug availability significantly varied among hospitals with different characteristics. A well-constructed questionnaire was designed according to the Chinese Guidelines for the Diagnosis and Management of COPD (revised version 2021). Both inhaled drugs (monotherapy, double therapy and triple therapy) and oral drugs (expectorants, theophylline, antibiotics, and bacterial lysates) were included in this survey. Doctors from different hospitals completed the survey via WeChat. The availability of each category and kind of drug was analyzed based on final valid responses. Subgroup analyses were also conducted to reveal drug availability in hospitals with different characteristics. A total of 1018 hospitals with different characteristics were enrolled in this survey, with 53.73% of which establishing independent respiratory departments. Insufficient supply of COPD-related drugs was observed, with only short-acting β2 agonists (80.6%), expectorants (88.2%) and antibiotics (84.3%) reaching 80%. Results of subgroup analyses suggested that primary hospitals were associated with poorer availability of all kinds of drugs than secondary and tertiary hospitals (all p < 0.001). Most inhaled drugs did not reach an availability of 20% in primary hospitals, except for salbutamol (59.7%), tiotropium bromide (20.0%) and beclometasone/formoterol (23.1%). Results of this survey suggested that the availability of drugs for COPD treatment in China is still an ongoing challenge for healthcare institutions. Insufficient drug supply and imbalanced drug availability among different hospitals are major barriers that warrant further improvements.
本调查旨在研究中国医院中用于稳定期慢性阻塞性肺疾病(COPD)治疗药物的可及性,并确定不同特征医院之间药物可及性是否存在显著差异。根据《慢性阻塞性肺疾病诊断与治疗中国指南(2021年修订版)》设计了一份结构完善的问卷。本调查纳入了吸入药物(单药治疗、双联治疗和三联治疗)和口服药物(祛痰药、茶碱、抗生素和细菌溶解产物)。来自不同医院的医生通过微信完成了调查。根据最终有效回复分析各类及各种药物的可及性。还进行了亚组分析以揭示不同特征医院的药物可及性。本调查共纳入了1018家不同特征的医院,其中53.73%设立了独立的呼吸科。观察到COPD相关药物供应不足,只有短效β2受体激动剂(80.6%)、祛痰药(88.2%)和抗生素(84.3%)的可及率达到80%。亚组分析结果表明,与二级和三级医院相比,基层医院各类药物的可及性较差(所有p < 0.001)。除沙丁胺醇(59.7%)、噻托溴铵(20.0%)和布地奈德/福莫特罗(23.1%)外,大多数吸入药物在基层医院的可及率未达到20%。本调查结果表明,中国COPD治疗药物的可及性对医疗机构来说仍然是一个持续存在的挑战。药物供应不足以及不同医院之间药物可及性不均衡是需要进一步改善的主要障碍。