Effects of One-Hour Training Course and Spirometry on the Ability of Physicians to Diagnose and Treat Chronic Obstructive Pulmonary Disease

Abstract

BackgroundsIn China, the prevalence of chronic obstructive pulmonary disease (COPD) in persons 40 years of age or older is estimated at 8.2%, but this is likely a substantial underestimate.MethodsEight secondary hospitals which didn’t have spirometries were chosen randomly in Hunan province of central south China. Physician subjects at these hospitals underwent a one-hour training course on the Chinese COPD guidelines. Physicians answered questionnaires assessing their knowledge of the guidelines before and after the training session. The mean correct scores of questionnaires were compared before and after training. Four out of the eight hospitals were given access to spirometry. Eligible patient subjects underwent spirometry testing prior to the physician visit. After seeing the patient, physicians were asked to answer a questionnaire relating to the diagnosis and severity of COPD. Physicians were then given the results of the spirometry, and asked to answer the same questionnaire. Physicians’ responses before and after receiving the spirometry results were compared.Results225 physicians participated in the training session. 207 questionnaires were completed. Mean scores (out of 100) before and after the training were 53.1 ± 21.7 and 93.3 ± 9.8, respectively. 18 physicians and 307 patient subjects participated in the spirometry intervention. Based on spirometric results, the prevalence of COPD was 38.8%. Physicians correctly identified the presence of COPD without spirometric data in 85 cases (76.6%); this increased to 117 cases (97.4%) once spirometric data were available. Without spirometric data, physicians incorrectly diagnosed COPD in 38 patients; this decreased to 6 patients once spirometric data were available. Spirometric data also improved the ability of physicians to correctly grade COPD severity.ConclusionsSimple educational training can substantially improve physicians’ knowledge relating to COPD. Spirometry combined with education improves the ability of physicians to diagnose COPD and to assess its severity.

The effect of acupoint application of traditional Chinese medicine for the treatment of chronic obstructive pulmonary disease

“…[ 22 ] In China, more than 1 million people died of COPD and more than 5 million people are disabled per year. [ 23 ] COPD is closely related to factors such as respiratory infection, dust, chemical inhalation, and air pollution. Importantly, AECOPD is often caused by microbial infections, [ 23 ] which may induce complications such as respiratory failure and sleep-disordered breathing.…”

“…[ 23 ] COPD is closely related to factors such as respiratory infection, dust, chemical inhalation, and air pollution. Importantly, AECOPD is often caused by microbial infections, [ 23 ] which may induce complications such as respiratory failure and sleep-disordered breathing. [ 24 – 26 ] Acute exacerbation increases the difficulty of treating COPD.…”

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“…This observation is similar to findings reported in other intervention studies. In these studies, knowledge, practice, acceptability, and repeatability improved in both training types: less than one day and the one day or more spirometry trainings, over a year with ongoing feedback training [12,14,17,[33][34][35] In a mentorship based intervention study by Gupta et al conducted over 12 months; there was a significant improvement in knowledge score post-intervention across all health workers that participated in that survey. Furthermore, Eaton et al [12] in another intervention study in New Zealand, reported a significant training effect between participants who had a oneday training and those who had no training (p < 0.0001).…”

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“…The changes in prescriptive patterns were most evident in the groups of patients with moderate and severe COPD. 69 …”