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Management of virtual COPD cases by pulmonary physicians




Esra Uzaslan1, Oguz Kilinc2, Aylin Konya3, Metin Akgun4 and Abdullah Sayiner5
1Department of Chest Diseases, Uludag University Medical Faculty, Bursa, Turkey,?2Department of Chest Diseases, Dokuz Eyl?l University Medical Faculty, Izmir, Turkey,?3Medical Management Department, Novartis Pharmaceuticals, Istanbul, Turkey,?4Department of Chest Diseases, Atat?rk University Medical Faculty, Erzurum, Turkey,?5Department of Chest Diseases, Ege University Medical Faculty, Izmir, Turke

This study aimed to assess pulmonary physicians' behaviors and decision processes in virtual COPD case management and affecting factors. 50 physicians were applied a questionnaire including 7 case scenarios: 2 newly diagnosed GOLD A cases; 2 exacerbation cases (GOLD B and D); 1 with comorbidities; 1 with asthma-COPD overlap syndrome, and 1 with obesity-hypoventilation syndrome, previously misdiagnosed as COPD. They examined anamnesis, laboratory and radiographic findings of each case and requested additional tests until a decision was made.

TABLE 1.
Pulmonary physicians' features
Duration of expertise
≤10 years 32(65.3)
>10 years 17(34.7)
Hospital
Training&Research 29(58.0)
Private 10(20.0)
State 9(18.0)
University 2(4.0)
Number of patients admitted to polyclinics daily 60(10-1000)
Mean number of patients examined daily/physician 40(8-90)
Physicians examining
≤35 patients daily 22(45.8)
>35 patients daily 26(54.2)
  • Data are shown as n(%) or median(min-max)

Of the physicians, 6% correctly diagnosed 7 cases and 44% correctly diagnosed 5 cases. There was no difference between the physicians' decision and occupational features. Work load was negatively correlated with correct diagnosis rate.

Prescribing correct treatment was associated with advanced disease. Physicians were prone to give correct treatment in advanced disease patients. They mostly preferred combination treatments and tended to use step-up treatment strategy.

We suggest that COPD management remains a problem.

http://erj.ersjournals.com/content/48/suppl_60/PA3686



PDPI Sulawesi Selatan & Utara. 05/04/17.



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