Variations in the Management of Acute Exacerbations of Chronic Obstructive Pulmonary Disease
Year: 2013
Type: article
Study design: Observational Study
Abstract: BACKGROUND: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are a significant cause of morbidity and mortality for patients with COPD. AECOPD are the leading cause of hospital admissions in Canada. Although multiple guidelines have been developed for the acute and chronic management of COPD, there are few quality assurance studies investigating adherence to these guidelines. METHODS: A retrospective chart review of all patients admitted to a tertiary care hospital in 2009 for an AECOPD was performed. Using a standardized data abstraction tool, adherence to current guidelines across different physician groups and patient outcomes were assessed. Particular focus was centred on differences in management across physician groups. RESULTS: Overall, 293 patients were evaluated. Of these, 82.6% were treated with one or more chronic COPD medication(s) in the community, with only 17.7% of patients treated with a long-acting inhaled anticholinergic medication. For treatment of AECOPD, 58% of patients received corticosteroids and 84% received antibiotics. Compared with general medicine and the hospitalist service, the respiratory medicine service demonstrated significantly better adherence with current treatment guidelines; however, even this was less than optimal. In addition, there was poor follow-up of patients cared for outside of the respiratory service. CONCLUSIONS: The present study identified significant care gaps in the treatment of patients admitted with AECOPD and on their discharge.
Source: Canadian Respiratory Journal
DOI: 10.1155/2013/501038
Institution: University of British Columbia
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,380
OpenAlex ID: W166364669