title: Evaluation of the visit frequency and the use of questionnaires and indices for COPD: a national survey from the On-Sint study.
abstract: BACKGROUND
  Despite widespread recommendations to use standardized questionnaires and multidimensional indices for the assessment of patients with chronic obstructive pulmonary disease (COPD), few data are available on the application of these tools in clinical practice. This study evaluates the attitude of physicians participating in the On-Sint cohort toward the use of health status questionnaires and multidimensional indices, as well as toward the frequency of visits and spirometry in primary care and specialized care.
  
  
  METHODS
  During the constitution of the On-Sint cohort, the participating physicians were surveyed about their clinical practice. They were questioned on the frequency of spirometry and visits and on the use of various questionnaires and indices. The health status questionnaires assessed were St. George's respiratory questionnaire, chronic respiratory questionnaire, airways questionnaire 20 and COPD assessment test (CAT). Physicians were also asked about the use of the medical research council (MRC) dyspnea scale and multidimensional indices such as body mass index, airflow obstruction, dyspnea, exercise capacity (BODE).
  
  
  RESULTS
  Of the 356 physicians who participated in the study, 258 (72.5 %) completed the investigator's questionnaire (185 primary care, 73 specialized care). Nonscheduled visits were inversely proportional to the severity of COPD. Overall, 34.1% reported using health status questionnaires, mainly CAT (20.9%). We found differences between primary and specialized care in the use of multidimensional indices (84.9% vs 47.6%; P < 0.001). Of all the participants, 33.3% reported using the MRC scale and 28.7% the BODE index.
  
  
  CONCLUSIONS
  Multidimensional indices and questionnaires are not commonly used with some differences between primary care and specialized care physicians. There is a considerable variability in the frequency of follow-up visits and spirometry.
authors.affiliation: Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, Spain.
authors.forename: Cecilia
authors.initials: C
authors.lastname: López Ramírez
authors.affiliation: Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Calero Acuña
authors.affiliation: Servicio de Neumología. Instituto de Investigación Biomédica de Vigo (IBIV), Complexo Hospitalario de Vigo, Spain.
authors.forename: Cristina
authors.initials: C
authors.lastname: Represas Represas
authors.affiliation: Servicio de Neumología. Instituto de Investigación Biomédica de Vigo (IBIV), Complexo Hospitalario de Vigo, Spain.
authors.forename: Luz
authors.initials: L
authors.lastname: Aballe Santos
authors.affiliation: Medical Department, Novartis Farmacéutica, Barcelona, Spain.
authors.forename: Ricard
authors.initials: R
authors.lastname: Casamor
authors.affiliation: Servicio de Neumología. Instituto de Investigación Biomédica de Vigo (IBIV), Complexo Hospitalario de Vigo, Spain.
authors.forename: Alberto
authors.initials: A
authors.lastname: Fernández-Villar
authors.affiliation: Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocio/Universidad de Sevilla, Spain.|Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain.
authors.forename: José Luis
authors.initials: JL
authors.lastname: López-Campos
mesh_terms: D000328:Adult; D000553:Ambulatory Care / Q000706:statistics & numerical data* / Q000639:trends; D001291:Attitude of Health Personnel; D015992:Body Mass Index; D015331:Cohort Studies; D004417:Dyspnea / Q000503:physiopathology; D017079:Exercise Tolerance / Q000502:physiology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000592:standards* / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000503:physiopathology; D011788:Quality of Life / Q000523:psychology; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013147:Spirometry / Q000379:methods; D011795:Surveys and Questionnaires / Q000592:standards*
keywords: chronic obstructive pulmonary disease - multidimensional indices - quality of life - questionnaires