Management of chronic obstructive pulmonary disease in Australia after the publication of national guidelines.
BACKGROUND
Information on the management of chronic obstructive pulmonary disease (COPD) in Australia, especially the extent of adherence to the COPD-X Plan, is sparse.


OBJECTIVE
To evaluate COPD patient adherence to treatment recommendations and healthcare provider adherence to the COPD-X Plan.


METHODS
Cross-sectional study of patients admitted to a secondary care hospital with an acute exacerbation of COPD over a 6-month period. Data were collected from patient interviews and medical notes.


RESULTS
Participants (n= 45) aged 72 ± 11.5 years (mean ± SD) had a mean FEV(1) % predicted 52.2 ± 18.7. At the time 11 (24.4%) patients continued to smoke; 25 (55.6%) had never participated in a pulmonary rehabilitation programme; and 23 (51.1%) self-reported poor adherence to some COPD medications. Inhaler technique was deemed suboptimal in 25 (55.6%) patients. Only 11 (24.4%) patients had received any instructions from their doctor regarding management of exacerbations. The use of medications not supported by the COPD-X guidelines were: long-term prednisolone (11, 24.4%) and prophylactic antibiotics (3, 6.7%).


CONCLUSIONS
Management of COPD in Australia by both patients and providers remains suboptimal despite the publication and wide dissemination of the COPD-X Plan, suggesting the need to intensify both patient and provider education in COPD management.
Ta
M
M
Southern Health Pharmacy Department, Casey Hospital and Department of Pharmacy Practice, Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Victoria, Australia. mai.ngoc@southernhealth.org.au
George
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D019468:Disease Management; D005260:Female; D019983:Guideline Adherence / Q000592:standards* / Q000639:trends; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic / Q000592:standards*; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000453:epidemiology* / Q000628:therapy*