Objectives: to determine modifiable risk factors of exacerbations in chronic respiratory diseases with airways obstruction (i.e., asthma and COPD) in southern Vietnam. Methods: an environmental and health-related behavioural questionnaire was submitted to patients with both chronic respiratory symptoms and airways obstruction. An exacerbation was defined as any acute worsening in clinical symptoms requiring a change in treatment, in a patient receiving prophylactic therapy. Results: 235 patients were evaluated, including 131 (56%) chronic obstructive pulmonary disease (COPD) and 104 (44%) asthmatics. There were 75% males and 69% smokers. Occupational exposure accounted for 66%, mainly among construction and industry workers. Smoking was associated with more severe airways obstruction. Respiratory exacerbations were reported in 56/235 patients (24%). The risk of exacerbation was increased in patients with a lower education level, exposure to occupational pollutants, cumulative smoking ≥ 20 pack year, housing space < 10 m2, and poorly ventilated housing. Based on multivariate analysis, the risk of exacerbation remained significantly higher among patients with occupational exposure and low housing space per person. Conclusions: besides smoking cessation, more supportive policies, including improvement of occupational environment and housing design for better ventilation, are needed to prevent the severity of chronic respiratory diseases in Vietnam.
Context: Vietnam is one of the countries at the high alert of antibiotic resistance. Aims: To evaluate the compliance rate and changes in physicians’ prescribing patterns in patients with community-acquired pneumonia (CAP) before and after using the antibiotic order form (AOF) in a tertiary hospital. Methods: 120 inpatient medical records having antibiotic use and 115 patient medical records diagnosed with CAP at a Department of Respiratory Medicine during 3 months before and 3 months after using the AOF were retrospectively collected for assessment. Results: The compliance rate was 92%, and the average rate of filling in information fields was 58%. Comparison of prescribing behavior of CAP in control and intervention group showed that the rate of bacterial culture increased from 70% to 77% (p = 0.690), in which the rate of culture prior prescribing administration increased from 14% to 45% (p < 0.001), the initial antibiotic regimen with narrow-spectrum increased from 26% to 36% (p = 0.353), the proportion of patients improved clinically after 72 hours increased from 64% to 89% (p = 0.138), and the de-escalation decreased from 23% to 20% (p = 0.713). The treatment failure at hospital discharge decreased from 12% to 6% (p = 0.447). However, the length of treatment and the days of antibiotic treatment were not significantly different. Conclusions: The compliance rate was high, but the AOF filling rate was incomplete. Improving prescribing patterns and treatment efficacy in CAP patients is a suggestion to combine the AOF into multifaceted interventional efforts for specific patients.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.