title: 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.
authors.affiliation: Federal University of Santa Catarina, Florianópolis, Brazil.
authors.forename: Irai Luis
authors.initials: IL
authors.lastname: Giacomelli
authors.affiliation: Federal University of Santa Catarina, Florianópolis, Brazil.
authors.forename: Leila John Marques
authors.initials: LJ
authors.lastname: Steidle
authors.affiliation: Federal University of Santa Catarina, Florianópolis, Brazil.
authors.forename: Frederico Fernandes
authors.initials: FF
authors.lastname: Moreira
authors.affiliation: Federal University of Santa Catarina, Florianópolis, Brazil.
authors.forename: Igor Varela
authors.initials: IV
authors.lastname: Meyer
authors.affiliation: Federal University of Santa Catarina, Florianópolis, Brazil.
authors.forename: Ricardo Goetten
authors.initials: RG
authors.lastname: Souza
authors.affiliation: Department of Clinical Medicine, Federal University of Santa Catarina, Florianópolis, Brazil.
authors.forename: Mariângela Pimentel
authors.initials: MP
authors.lastname: Pincelli
mesh_terms: D000368:Aged; D001938:Brazil; D002985:Clinical Protocols; D003430:Cross-Sectional Studies; D005260:Female; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D010818:Practice Patterns, Physicians'; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000628:therapy*; D012959:Socioeconomic Factors; D013147:Spirometry; D011795:Surveys and Questionnaires