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Int J Chron Obstruct Pulmon Dis ; 3(4): 803-14, 2008.
Artigo em Inglês | MEDLINE | ID: mdl-19281096

RESUMO

AIMS: Data on differences in clinical characteristics and management of COPD in different countries and settings are limited. We aimed to characterize the profile of patients with COPD in a number of countries and their treatment in order to evaluate adherence to recommendations of international guidelines. METHOD: This was an observational, international, cross-sectional study on patients with physician-diagnosed COPD. Demographic and clinical characteristics, risk factors, and treatment were collected by their physician via an internet web-based questionnaire developed for the study. RESULTS: A total of 77 investigators from 17 countries provided data on 833 patients. The countries with the highest number of patients included were: Argentina (128), Ecuador (134), Spain (162), and Hong Kong (153). Overall, 79.3% were men and 81% former smokers, with a mean FEV1 = 42.7%, ranging from 34.3% in Hong Kong to 58.8% in Ecuador. Patients reported a mean of 1.6 exacerbations the previous year, with this frequency being significantly and negatively correlated with FEV1 (%) (r = -0.256; p < 0.0001). Treatment with short-acting bronchodilators and theophyllines was more frequent in Ecuador and Hong Kong compared with Spain and Argentina, and in patients belonging to lower socioeconomic levels (p < 0.0001 for all comparisons). Inadequacy of treatment with inhaled corticosteroids and theophyllines was high, with significant differences among countries. CONCLUSIONS: Differences in the clinical characteristics and management of COPD were significant across countries. Adherence to international guidelines appears to be low. Efforts should be made to disseminate and adapt guidelines to the socioeconomic reality of different settings.


Assuntos
Disparidades nos Níveis de Saúde , Disparidades em Assistência à Saúde , Padrões de Prática Médica , Doença Pulmonar Obstrutiva Crônica/diagnóstico , Doença Pulmonar Obstrutiva Crônica/terapia , Características de Residência , Medicamentos para o Sistema Respiratório/uso terapêutico , Administração por Inalação , Corticosteroides/uso terapêutico , Idoso , Idoso de 80 Anos ou mais , Broncodilatadores/uso terapêutico , Estudos Transversais , Uso de Medicamentos , Feminino , Volume Expiratório Forçado , Fidelidade a Diretrizes , Pesquisas sobre Atenção à Saúde , Disparidades em Assistência à Saúde/estatística & dados numéricos , Humanos , Cooperação Internacional , Internet , Masculino , Pessoa de Meia-Idade , Guias de Prática Clínica como Assunto , Padrões de Prática Médica/estatística & dados numéricos , Medicamentos sob Prescrição/uso terapêutico , Estudos Prospectivos , Doença Pulmonar Obstrutiva Crônica/epidemiologia , Doença Pulmonar Obstrutiva Crônica/fisiopatologia , Características de Residência/estatística & dados numéricos , Medicamentos para o Sistema Respiratório/administração & dosagem , Classe Social , Inquéritos e Questionários , Teofilina/uso terapêutico , Resultado do Tratamento
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