| Title |
Determinants for changing the treatment of COPD: a regression analysis from a clinical audit
|
|---|---|
| Published in |
International Journal of Chronic Obstructive Pulmonary Disease, June 2016
|
| DOI | 10.2147/copd.s103614 |
| Pubmed ID | |
| Authors |
Jose Luis López-Campos, María Abad Arranz, Carmen Calero Acuña, Fernando Romero Valero, Ruth Ayerbe García, Antonio Hidalgo Molina, Ricardo I Aguilar Perez-Grovas, Francisco García Gil, Francisco Casas Maldonado, Laura Caballero Ballesteros, María Sánchez Palop, Dolores Pérez-Tejero, Alejandro Segado, Jose Calvo Bonachera, Bárbara Hernández Sierra, Adolfo Doménech, Macarena Arroyo Varela, Francisco González Vargas, Juan J Cruz Rueda |
| Abstract |
This study is an analysis of a pilot COPD clinical audit that evaluated adherence to guidelines for patients with COPD in a stable disease phase during a routine visit in specialized secondary care outpatient clinics in order to identify the variables associated with the decision to step-up or step-down pharmacological treatment. This study was a pilot clinical audit performed at hospital outpatient respiratory clinics in the region of Andalusia, Spain (eight provinces with over eight million inhabitants), in which 20% of centers in the area (catchment population 3,143,086 inhabitants) were invited to participate. Treatment changes were evaluated in terms of the number of prescribed medications and were classified as step-up, step-down, or no change. Three backward stepwise binominal multivariate logistic regression analyses were conducted to evaluate variables associated with stepping up, stepping down, and inhaled corticosteroids discontinuation. The present analysis evaluated 565 clinical records (91%) of the complete audit. Of those records, 366 (64.8%) cases saw no change in pharmacological treatment, while 99 patients (17.5%) had an increase in the number of drugs, 55 (9.7%) had a decrease in the number of drugs, and 45 (8.0%) noted a change to other medication for a similar therapeutic scheme. Exacerbations were the main factor in stepping up treatment, as were the symptoms themselves. In contrast, rather than symptoms, doctors used forced expiratory volume in 1 second and previous treatment with long-term antibiotics or inhaled corticosteroids as the key determinants to stepping down treatment. The majority of doctors did not change the prescription. When changes were made, a number of related factors were noted. Future trials must evaluate whether these therapeutic changes impact clinically relevant outcomes at follow-up. |
X Demographics
The data shown below were collected from the profile of 1 X user who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 1 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Practitioners (doctors, other healthcare professionals) | 1 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 42 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 42 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 10 | 24% |
| Researcher | 6 | 14% |
| Other | 3 | 7% |
| Student > Bachelor | 3 | 7% |
| Professor | 3 | 7% |
| Other | 9 | 21% |
| Unknown | 8 | 19% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 14 | 33% |
| Nursing and Health Professions | 4 | 10% |
| Pharmacology, Toxicology and Pharmaceutical Science | 4 | 10% |
| Social Sciences | 3 | 7% |
| Engineering | 2 | 5% |
| Other | 4 | 10% |
| Unknown | 11 | 26% |
Attention Score in Context
This research output has an Altmetric Attention Score of 1. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 03 June 2016.
All research outputs
#20,657,128
of 25,374,917 outputs
Outputs from International Journal of Chronic Obstructive Pulmonary Disease
#2,078
of 2,577 outputs
Outputs of similar age
#269,925
of 353,658 outputs
Outputs of similar age from International Journal of Chronic Obstructive Pulmonary Disease
#70
of 83 outputs
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