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Quality of Care of Acute Exacerbations of COPD and Asthma in Adults: A Phone Survey in Ukraine FREE TO VIEW

Ivan Vyshnyvetskyy*, PhD; Olga Khitrenko, MD; Tetiana Kugler, MD
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Donetsk National Medical University, Donetsk, Ukraine

Chest. 2012;142(4_MeetingAbstracts):418A. doi:10.1378/chest.1388728
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SESSION TYPE: Improving Processes and Outcomes in Adult Critical Care

PRESENTED ON: Wednesday, October 24, 2012 at 02:45 PM - 04:15 PM

PURPOSE: To investigate the knowledge and practice patterns concerning treatment of acute exacerbations of COPD and asthma in Ukrainian GPs.

METHODS: We performed a telephone survey of 85 GPs in Donetsk region, Ukraine. As an indicator of quality of care we used answers on two open questions: "How do you treat prolonged acute bronchial obstruction (BO) in COPD or asthma?" and "Which medication of those you mentioned is principal for resolution of obstruction?" The concordance of answers to international and local guidelines was analyzed.

RESULTS: Twenty three (27%) GPs and 29 (34%) GPs did not indicate SABA and corticosteroids (systemic or inhaled), respectively, as a part of treatment of acute BO. Forty two (49%) doctors use only parenteral dexametasone and just 2 GPs prescribe oral forms of steroids if indicated. Even in severe exacerbations only 2 and 3 GPs use oxygen and SAMA, respectively. On the whole, excluding oxygen, all necessary components of treatment are used by 36 (42%) GPs. Forty seven (55%) GPs indicated medications or approaches that do not fit current guidelines or have limited evidence base: IV aminophylline (33%), LABA or LAMA (30%) and others (mucolytics, hydratation, LTRA, fenspiride) (16%). Thus, only 19 (22%) GPs usually prescribe all compulsory medications (with minor reservations) and do not prescribe unproved approaches or those with low grades of recommendations according to current guidelines.

CONCLUSIONS: The knowledge of guidelines requirements concerning treatment of acute exacerbations of COPD and asthma is insufficient. In Ukraine quality of care of acute exacerbations of COPD and asthma in adults is poor.

CLINICAL IMPLICATIONS: In Ukraine urgent educational and organisational actions are needed to improve knowledge of evidence-based treatment of acute exacerbations of COPD and asthma and GPs to comply with current guidelines.

DISCLOSURE: The following authors have nothing to disclose: Ivan Vyshnyvetskyy, Olga Khitrenko, Tetiana Kugler

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Donetsk National Medical University, Donetsk, Ukraine




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