A case scenario study on adherence to COPD GOLD recommendations by general practitioners in a rural area of southern Italy: The 'progetto PADRE'
| Autor: | Mario Cazzola, Salvatore Fuschillo, Alberto De Felice, Mauro Maniscalco, Michele Martucci, Silvestro Ennio D'Anna |
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| Rok vydání: | 2020 |
| Předmět: |
Pulmonary and Respiratory Medicine
Spirometry Rural Population medicine.medical_specialty medicine.medical_treatment Diagnostic Techniques Respiratory System Pulmonary Disease Chronic Obstructive General Practitioners Medicine Humans Pulmonary rehabilitation Practice Patterns Physicians' Anamnesis COPD Chest physician medicine.diagnostic_test Primary Health Care business.industry medicine.disease Obstructive lung disease Clinical Practice Italy Family medicine Practice Guidelines as Topic Guideline Adherence Rural area business |
| Zdroj: | Respiratory medicine. 170 |
| ISSN: | 1532-3064 |
| Popis: | The aim of the present study was to evaluate in a sample of 200 patients diagnosed with COPD and selected from the physician database of 15 general practices from Valle Telesina (Benevento, Italy) if the diagnostic-therapeutic algorithm adopted by GPs operating in a non-urban district in Southern Italy adhered to GOLD 2018 recommendations for COPD. Each patient underwent a specialist visit by an experienced chest physician that collected anamnesis, assessed mMRC and CAT scores, and performed a spirometry. In case of diagnostic doubt, a second visit was performed at the Pulmonary Rehabilitation Unit of the Istituti Clinici Scientifici Maugeri IRCCS in Telese Terme where other diagnostic tests were performed. Our results showed that GPs participating in the study often diagnosed and empirically treated COPD without a confirmative spirometry or even despite a spirometry that was not diagnostic of obstructive lung disease. Furthermore, real-life implementation of GOLD strategy, as regards patients’ ABCD categorization, was poor and many patients belonging to groups A and B (39% and 48%, respectively) were over-treated and 19% of those belonging to group D were under-treated. The discrepancy between guidelines and daily clinical practice present also in this study supports the opinion of many that those who develop guidelines for the management of COPD must seriously try to understand if and why the guidelines might not reflect real life and therefore how it could be improved. |
| Databáze: | OpenAIRE |
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