title: Clinical outcomes of multidisciplinary care in chronic obstructive pulmonary disease patients at the Central Chest Institute of Thailand.
abstract: OBJECTIVE
  To compare clinical outcomes before and after are enrolled study within 1 year and factors related to Chronic Obstructive Pulmonary Disease (COPD) exacerbations after enrolled.
  
  
  METHODS
  COPD patients who were compatible with inclusion criteria in COPD clinic at the Central Chest Institute of Thailand between March 2007 and July 2010. Baseline characteristics, COPD management program, bronchodilator used, and clinical outcomes were recorded by a search of retrospective databases, as well as the patient medical records.
  
  
  RESULTS
  A total of 247 enrolled patients compatible with inclusion criteria were analyzed. Most of the patients were male, 240 patients (97.2%). The average age of the patients was 69.3 +/- 9.1 years. The majority of patients were in GOLD stage II, 121 patients (49.0%). After multidisciplinary care was performed. In an overall 219 patients (88.6%) of COPD patients received appropriate bronchodilator treatment classified by GOLD stage which had different proportions in each stage significantly [stage I = 45 patients (100%), stage II = 103 patients (86.6%), stage III = 58 patients (86.6%), stage IV = 13 patients (92.8%),p = 0.026]. COPD exacerbations frequency (0.9 +/- 1.6 vs. 0.3 +/- 0.9, p<0.001), COPD related-hospitalizations (0.2 +/- 0.8 vs. 0.1 +/- 0.4, p < 0.001), COPD related-respiratory failure (0.04 +/- 0.25 vs. 0.008 +/- 0.090, p = 0.020) were significantly decreased after enrolled. On multivariate analysis, COPD patients who had exacerbations frequency more than one time per year were prone to have repeated COPD exacerbations approximately three times more than other COPD patients (Adjusted Odds ratio 2.80, 95% CI, 1.08 to 7.26, p = 0.034).
  
  
  CONCLUSIONS
  Multidisciplinary care in COPD patients can significantly improve clinical outcomes.
authors.affiliation: Department of Pulmonary Medicine, Central Chest Institute of Thailand, Nonthaburi, Thailand. kpanjapornpon@yahoo.com
authors.forename: Kanlaya
authors.initials: K
authors.lastname: Panjapornpon
authors.forename: Sonklin
authors.initials: S
authors.lastname: Tanont
mesh_terms: D000368:Aged; D001993:Bronchodilator Agents / Q000627:therapeutic use*; D057186:Comparative Effectiveness Research; D019468:Disease Management; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008499:Medical Records / Q000706:statistics & numerical data; D008875:Middle Aged; D015999:Multivariate Analysis; D010043:Outcome and Process Assessment, Health Care; D010348:Patient Care Team / Q000706:statistics & numerical data*; D029424:Pulmonary Disease, Chronic Obstructive / Q000453:epidemiology / Q000503:physiopathology / Q000628:therapy; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013785:Thailand / Q000453:epidemiology
chemical_list: D001993:Bronchodilator Agents