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Characteristics of COPD Patients Managed in Respiratory Medicine Departments in Spain, According to GOLD Groups and GesEPOC Clinical Phenotypes

The objective of this study was to analyze the clinical characteristics of COPD patients attending general respiratory clinics, adherence to clinical guidelines, classification accuracy, and therapeutic management. Multicenter, cross-sectional study, with the primary objective of describing the numb...

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Bibliographic Details
Published in:Archivos de bronconeumología (English ed.) 2018-11, Vol.54 (11), p.559-567
Main Authors: Izquierdo, José Luis, Miravitlles, Marc, Esquinas, Cristina, Pérez, Maite, Calle, Myriam, López Campos, José Luis, Rodríguez González-Moro, José Miguel, Casanova, Ciro, Esteban, Cristóbal, de Lucas, Pilar
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Language:English
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Summary:The objective of this study was to analyze the clinical characteristics of COPD patients attending general respiratory clinics, adherence to clinical guidelines, classification accuracy, and therapeutic management. Multicenter, cross-sectional study, with the primary objective of describing the number, intensity, and variability of symptoms in COPD patients. Data were collected in 2015 by 300 pulmonologists who evaluated a total of 3010 patients, of which 2669 (88.6%) were eligible for analysis. A total of 22% were active smokers, notably 21% and 17% of GOLD groups C and D, and 17% and 19% of exacerbators in the GesEPOC classification; 62.3% had associated comorbidities. The diagnostic process was characterized by limited use of tests such as diffusion capacity or lung volumes, even in the more severe GOLD groups or the GesEPOC exacerbator phenotypes. The use of multidimensional scales, such as BODE (12%), and specific rehabilitation protocols was also rare. Treatment was based on different combinations of bronchodilators and inhaled corticosteroids. Methylxanthines were used in very few patients (7%). A large proportion of COPD patients seen in respiratory clinics have non-complex disease and pulmonology tests are rarely performed. Our study confirms a slight change in treatments and the frequent association with comorbidities that can modify the clinical presentation of the patient. El objetivo de este estudio ha sido analizar las características clínicas de los pacientes con EPOC vistos en las consultas generales de neumología, el seguimiento de las guías clínicas y la adecuación en la categorización y en el manejo terapéutico. Estudio multicéntrico, transversal, cuyo objetivo primario es describir el número, intensidad y variabilidad de los síntomas en los pacientes con EPOC. La recogida de los datos fue realizada en 2015 por 300 neumólogos que evaluaron un total de 3.010 pacientes, de los cuales 2.669 (88,6%) fueron válidos para el análisis. El 22% eran fumadores activos, destacando un 21 y 17% en los grupos C y D de GOLD y un 17 y 19% en los pacientes exacerbadores de GesEPOC. El 62,3% presentaba comorbilidades asociadas. En el proceso diagnóstico destaca el bajo uso de pruebas como el test de difusión o la medición de volúmenes pulmonares, incluso en los grupos más graves de GOLD o en los fenotipos exacerbadores de GesEPOC. También es minoritario el uso de escalas multidimensionales como BODE (12%) o programas específicos de rehabilitación. El trata
ISSN:1579-2129
1579-2129
DOI:10.1016/j.arbr.2018.09.006