METHODS: The charts of 2291 patients diagnosed with COPD were retrospectively analyzed, of which 1438 matched the eligibility criteria.
RESULTS: The average patient age was 69.6 ± 10.9 years; 52% of patients were female. The average COPD assessment test (CAT) score was 18.3 ± 9.1. The ABCD breakdown was as follows: group A 19.5%, group B 64.1%, group C 1.8%, and group D 14.6%. All groups, except group D, showed discordance in COPD treatment relative to the proposed GOLD guidelines. Only 18.9% of group A and 26% of group B were treated in concordance with the guidelines. TT was primarily used in group D (63.3%) and overused in groups A (30.6%) and B (47.8%). ICS was overused in all groups, particularly in groups A (56.2%) and B (67.3%).
CONCLUSIONS: Studies from the last decade have consistently revealed a lack of conformity between what physicians prescribe and what GOLD guidelines recommend. The excessive usage of ICS, which continues despite all the associated adverse effects and the attributable costs, is concerning. The awareness of GOLD guidelines among primary care physicians (PCPs) and respiratory specialists needs to be improved.
方法:对2291例确诊为COPD的患者进行回顾性分析,其中1438项符合资格标准。
结果:患者平均年龄为69.6±10.9岁;52%的患者为女性。COPD评估测试(CAT)平均得分为18.3±9.1。ABCD分解如下:A组19.5%,B组64.1%,C组1.8%,D组14.6%。所有团体,除了D组,显示COPD治疗与拟议的GOLD指南不一致。只有18.9%的A组和26%的B组按照指南进行了治疗。TT主要用于D组(63.3%),过度用于A组(30.6%)和B组(47.8%)。ICS在所有组中都被过度使用,特别是A组(56.2%)和B组(67.3%)。
结论:过去十年的研究一直表明,医生的处方与GOLD指南的建议之间缺乏一致性。ICS的过度使用,尽管存在所有相关的不利影响和可归属成本,是关于的。需要提高初级保健医生(PCP)和呼吸专家对GOLD指南的认识。