Encuesta a neumonologos sobre el diagnostico y tratamiento de EPOC / Survey of chest physicians regarding COPD diagnosis and treatment

ABSTRACT

A survey on COPD diagnostic procedures, treatment and management was conducted in a group of 517 chest physicians randomized from a list of the 1121 affiliates to the Asociación Argentina de Medicina Respiratoria. One hundred eighty-seven responses were obtained (36.2% of the questionnaires mailed). They treat an average of 53.3 COPD patients every month. Twenty-four percent of them had mild, 41.8% moderate and 33.8% severe disease (GOLD criteria). Only clinical criteria for diagnosis of COPD, clinical criteria + spirometry (S), and clinical criteria + S + chest X ray were used by 2.9, 23.4 and 73.7% of responders, respectively. Seventy percent of responders believed that chronic asthma without bronchodilator response must be included in the COPD definition. Only 14.1% of responders performed S in every office visit. Cardiac function was assessed using clinical criteria, electrocardiogram and echocardiogram by 90.6, 80.6 and 73.8% of responders, respectively, while 98.3% stated that they trained most of their patients in the inhalation technique. Metered Dose Inhaled was the first option for bronchodilators administration (64.8%) followed by nebulization (16.5%), dry powder inhalation (13.7%) and oral administration (4.8%). First option for chronic therapy in severe COPD patients was the association of anticholinergic drug (AC) + short acting beta2-agonists (SABA) (65.5%), AC alone (18.8%), long acting beta2-agonists (LABA) (9.7%), inhaled corticosteroids (IC) (3.5%) and SABA alone (2.8%). Corticosteroids and antibiotics were prescribed in severe COPD exacerbation by 92.5 and 70% of responders, respectively. First choice antibiotic formulation was beta-lactamics + beta-lactamase inhibitors in 39% of the responders followed by fluorquinolones in 23.7%, macrolides in 17.5% and beta-lactamics in 12.5%. Lastly, 12.7% of COPD patients received long-term domiciliary oxygen therapy. 59.3% of them were prescribed pulmonary rehabilitation, 94.1% vaccination against in...(AU)