Pulmonary Manifestations of Systemic Disease: Pulmonary Manifestation of Systemic Disease |

Is Variation on Following the GOLD Guidelines Provider Dependent? FREE TO VIEW

Timothy Murphy, DO; Stephen Eikermann, DO; Antonio Guzman, MD; David Vanderheiden, DO; Alamgir Khan, MD; Salim Surani, MD
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Corpus Christi Medical Center, Corpus Christi, TX

Copyright 2016, American College of Chest Physicians. All Rights Reserved.

Chest. 2016;150(4_S):1070A. doi:10.1016/j.chest.2016.08.1177
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SESSION TITLE: Pulmonary Manifestation of Systemic Disease

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 26, 2016 at 01:30 PM - 02:30 PM

PURPOSE: Over 12 million people in the world live with COPD and the direct health care costs are projected to increase to $49 billion by 2020. Because the prevalence and overall importance of COPD as a health problem and financial burden is increasing, we undertook this study to look at the variations in accurately diagnosing to manage patients with symptoms of COPD in two community clinics.

METHODS: After approval from the local IRB, a retrospective chart review was done among all patients with the diagnosis of COPD in two community clinics. Baseline demographics, utilization of spirometry, exacerbation history and home oxygen use were also obtained.

RESULTS: Chart reviews of 100 patients were completed (51 Male; 49 female) in two outpatient primary care provider (PCP) offices (Office A: 65 patients; Office B: 35 patients). In office A, an average age was 70.27 (+/-10.88) years compared to an average age of 71.82 (+/-14.77) years in office B. In office A, 29% (19/65) of the patients had PFTs done and 69% (13/19) of patients met criteria for the diagnosis of COPD, whereas 31.5% of patients were wrongly mislabeled as COPD. In office B, 8.6% (3/35) had PFTs, whereas 91.4% were diagnosed clinically or empirically.

CONCLUSIONS: Significant numbers of patients in the community clinics were either diagnosed clinically with COPD or wrongly labeled as COPD. There was significant variation seen in getting the spirometry or any attempt to accurately diagnose the patients with COPD.

CLINICAL IMPLICATIONS: The management of two separate patient populations was significantly different and provider dependent. Tools for education of health care providers on the new guidelines should be implemented for more accurate and consistent diagnosis of this growing health problem.

DISCLOSURE: The following authors have nothing to disclose: Timothy Murphy, Stephen Eikermann, Antonio Guzman, David Vanderheiden, Alamgir Khan, Salim Surani

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