[Effectiveness of treatment with tiotropium in patients who suffer from COPD]. / Efectividad del tratamiento con bromuro de tiotropio en pacientes con enfermedad pulmonar obstructiva crónica.

BACKGROUND AND OBJECTIVE: We assessed the clinical and functional changes taking place in patients diagnosed of chronic obstructive pulmonary disease (COPD) who have been treated with ipratropium bromide, three months after this medicament was replaced by the new tiotropium bromide. PATIENTS AND METHOD: A prospective intervention survey was carried out in a primary health-care area in patients who suffered from COPD who fulfilled the inclusion criteria. Before changing the treatment and three months after changing it, we carried out the following procedures: spirometry, 6 minutes walking test (6MWT) with pulsioximetry before and after the exercise, St. George Respiratory Questionnaire (SGRQ) and assessment of: patient's chronic dyspnea, degree of patient's compliance, adverse effects and degree of satisfaction with the new drug. RESULTS: 24 patients (22 males and 2 females) with a mean age of 68.54 years participated in the survey. The FVC improved a 4.92% (120 ml) [p = .27] and the FEV1, 14.16% (170 ml) [p < .001]. The degree of compliance arose from 67.54% to 96.73% (p < .001), the degree of dyspnea decreased from 4.63 to 3.89 (p = .141), the 6MWT increased in 23.79 m (p = .027) and the global mark of the SGRQ reduced (improved) in 13.35 points. There were adverse effects in 5 cases (mouth dryness in 4 patients and headache in 1 of them) and 15 patients (62.5%) said the new drug was better. CONCLUSIONS: Most analyzed parameters had positive changes three months after changing the treatment. Tiotropium may be a valid alternative in the treatment of patients suffering from COPD in a stable stage.