DOCTORS' FAILURE IN OBSERVANCE OF THE COPD MANAGEMENT GUIDELINES- THE CZECH REPUBLIC 2015 UPDATE
Author(s)
Zigmond J1, Vitova V1, Koblizek V2, Zatloukal J3, Kolek V3
1CEEOR s.r.o., Prague, Czech Republic, 2Charles University, Faculty of Medicine and University Hospital, Hradec Kralove, Czech Republic, 3Olomouc University Hospital, Olomouc, Czech Republic
OBJECTIVES: The primary objective of this study was to update the results of the examination of GOLD 2011 COPD management recommendation implementation among the Czech respiratory specialists with respect to the patients' classification. The secondary objective was to explore effect of a misclassification on the use of inhaled corticosteroids (ICS). METHODS: Multicenter cross-sectional study was conducted among COPD specialists, consisting of general questionnaire and patient-specific forms. A subjective classification into the GOLD 2011 groups as practiced by the healthcare professionals was examined and then compared with the objective classification achieved by rigorous software-computed classification. RESULTS: There were significant differences between patient’s objective and subjective GOLD classification. The ratio in percent of the patients was as follows: A 26.4/14.9, B 20.0/28.4, C 12.7/24.3 and D 40.9/30.8. The best match was found between D category, followed by B, A and C. About 45% of the doctors assign patients to the GOLD category incorrectly disregarding whether they were using GOLD classification or not. One sixth of the patients received inhalation corticosteroids, half of those incorrectly. About four percent of the patients received iPDE4, half of those incorrectly. More than two thirds of the patients (75.9%) received LABA in any combination or alone. About half of the patients (57.4% and 46.3%) received LAMA or ICS in any combination or alone. Three most common objectively assign phenotypes were emphyzematic, bronchitic and repeated exacerbations phenotypes. The same results were obtained for subjectively assign phenotypes. The most common objective overlap phenotypes were bronchitic & emphyzematic, bronchitic & repeated exacerbations and bronchitic & emphyzematic & repeated exacerbations overlap phenotypes. The same results were obtained for subjective phenotypes. CONCLUSIONS: Despite high awareness of the GOLD 2011 guidelines, its implementation is insufficient. Doctors therefore both assign patients to the wrong GOLD category and prescribe inadequate drugs, specifically ICS.
Conference/Value in Health Info
2015-11, ISPOR Europe 2015, Milan, Italy
Value in Health, Vol. 18, No. 7 (November 2015)
Code
PRS5
Topic
Epidemiology & Public Health
Topic Subcategory
Disease Classification & Coding
Disease
Respiratory-Related Disorders