Hospitalized patients with COPD: analysis of prior treatment

Abstract

Objective: Although COPD is a prevalent disease, it is undertreated, and there are no available data regarding previous treatment of COPD in Brazil. This study aimed to determine the appropriateness of maintenance treatment in COPD patients prior to their hospitalization and to identify variables associated with inappropriate treatment. Methods: This was an observational, cross-sectional, analytical study involving 50 inpatients with COPD at two hospitals in the city of Florianópolis, Brazil. The patients completed a questionnaire on parameters related to the maintenance treatment of COPD. Non-pharmacological management and pharmacological treatment were assessed based on the recommendations made by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) in 2011 and by the Brazilian National Ministry of Health in the chronic respiratory diseases section of its Caderno de Atenção Básica (CAB, Primary Care Guidebook). Results: In most of the patients, the COPD was classified as being severe or very severe. Regarding non-pharmacological management, 33% of the patients were smokers, only 32% had been advised to receive the flu vaccine, 28% had received pneumococcal vaccine, and only 6.5% of the patients in the B, C, and D categories received pulmonary rehabilitation. Regarding GOLD and CAB recommendations, pharmacological treatment was inappropriate in 50% and 74% of the patients, respectively. Based on GOLD recommendations, 38% were undertreated. A low level of education, low income, not receiving oxygen therapy, and not receiving the flu vaccine were associated with inappropriate treatment. Conclusions: The application of various non-pharmacological management recommendations was unsatisfactory. Regarding the GOLD recommendations, the high rate of inappropriate maintenance treatment was mainly due to undertreatment. In Brazil, even in severe COPD cases, optimizing treatment to achieve greater benefits continues to be a challenge.

Capacidade Funcional Em Indivíduos Com Doença Pulmonar Obstrutiva Crônica Em Uma Cidade Do Alto Paranaíba-Mg

“…bronquite crônica, caracterizada por uma tosse hipersecretora com sequência a obstrução brônquica e o enfisema pulmonar, caracterizado pela destruição alveolar e espaçamento anormal dos brônquios aéreos distais. É comum entre estes indivíduos a presença de sinais e sintomas como dispnéia, alteração na ventilação/perfusão, hiperinsuflação pulmonar, respiração sibilante, fadiga durante as práticas de atividade física, perda de retração elástica, destruição alveolar (Dourado et al, 2006;Loivos, 2009;Sousa, 2011 Com decorrência da utilização das condutas, obter uma melhor qualidade de vida nesse grupo de indivíduos (Giacomelli et al 2014;Sousa, 2019;Corrêa et al, 2011).…”

Produção Do Cuidado E a Rede De Atenção a Pessoa Com Doença Respiratória Crônica: Um Estudo De Revisão

“…Ou seja, vai além das questões que envolvem os estabelecimentos, ou apenas o acesso, mais, a qualidade dos trabalhadores na rede de atenção também deve ser um ponto a ser interrogado 22,23 .…”

Clinical and symptomatological reflections: the fascial system

“…Once altered, the fascial continuum generates a symptomatology that deteriorates the health condition of the patient, very often developing symptoms that are more significant than the clinical parameters diagnosed through medical diagnostic devices 38–41. Chronic fatigue, for instance, can be associated with the fascial system, particularly when the pathological disorder has persisted for several years 42.…”