An impact of acute exacerbation of COPD (AECOPD) on the course and the prognosis of chronic obstructive pulmonary disease depends on severity of the exacerbation. Moderate and severe exacerbations are considered as clinically significant events. Clinical studies investigating a role of inhalational therapy for the risk of AECOPD differed significantly in important parameters and the patients involved were not fully described in the real clinical practice. Tiotropium alone did not demonstrate any benefit over other inhalational therapies, such as inhaled corticosteroid/long-acting β2-agonist (ICS/LABA) combinations and long-acting muscarinic antagonist (LAMA)/LABA combinations, for risk reduction of moderate to severe exacerbations. A benefit of tiotropium/olodaterol combination over tiotropium for the reduction of risk of clinically significant exacerbations was first shown in DYNAGITO study; patients’ groups in this study did not differ in a rate and a spectrum of adverse events including cardiovascular events. An efficient bronchodilating therapy should be administered to all patients with COPD as it could improve dyspnea and prevent exacerbations. Further escalation of treatment in patients with frequent exacerbations of COPD should be personalized according to clinical course and causes of AECOPD.
Introduction: Bronchial asthma is a disease characterized by chronic inflammation of the airways. At present, about 235-300 million people suffer from asthma, and this number continues to grow. This pathology is also common in children. It causes significant social and economic damage worldwide. Severe forms of asthma are difficult to treat. Thus, a continuous improvement of doctors' knowledge in this field is of great importance.
Methods:The analysis of an anonymous survey of physicians and senior medical students was used in the research.
Results:The study revealed both an average level of basic knowledge in asthma etiology and pathogenesis among the physicians and senior medical students and the significant differences in their knowledge regarding clinical picture and treatment of asthma. Only 49.2% of students and 56.0% of doctors were able to choose the correct definition of asthma from the suggested answers; 65.7% of students and 69.9% of doctors correctly indicated the main clinical and laboratory markers of asthma; 60.2% of students and 91.0% of doctors determined the correct combination of drugs in one delivery device; and 75.9% of students and 91.2% of doctors selected the correct basic asthma therapy depending on the severity.
Introduction: Chronic obstructive pulmonary disease (COPD) is one of the most common pathologies of the respiratory system. This disease ranks third in the group of the main causes of death in the world. The effective treatment of COPD has been developed by today. However, a significant part of physicians has an insufficient amount of education in this matter.
Materials and methods: The article represents the results of anonymous prospective survey within the ASCO project (full title – “Assessment of Senior Medical Students in the Field of COPD”), aimed at assessing the basic knowledge in the COPD treatment. The survey involved 321 physicians and 221 senior medical students from ten cities of Russia and Ukraine.
Results and discussion: According to the survey, the following levels of correct answers were given by the doctors and students: possible fixed combinations of β2-agonist – 33.9% and 24.5%; the optimal delivery device for a patient – 50.8% and 41.8; the correct drugs for COPD initial therapy with a high risk of exacerbations – 31.7% and 15.3%, and with a low risk – 54.9% and 25.9%, respectively. The correct drugs for COPD aggravation were selected by 43.3% of doctors and 34.5% of students; the right empirical treatment of COPD infectious exacerbation – by 72.4% and 40%, and the correct reserve drugs – by 63.9% and 36.2%, respectively.
Conclusion: The survey showed that the respondents had medium level of knowledge in COPD treatment. Hence, curricula need to be adjusted in medical universities, and additional educational activities are required for medical practitioners in order to improve the quality of their knowledge in this field.
Introduction. Arterial hypertension (AH) is a syndrome accompanied by an increase in systolic blood pressure (BP)140 mmHg and/or diastolic BP90 mmHg. It is a progressive pathology that affects the adult employable population and leads to the development of deadly complications.
Aim. To compare the level of physicians knowledge in AHs definition, diagnosis and treatment in different centers of Russia.
Materials and methods. In the framework of the multicenter study PHYSTARH (the full name of the project Physicians and undergraduates knowledge in arterial hypertension treatment), which was launched in 2017, an anonymous survey was conducted among 425 doctors from 9 cities/regions of Russia (Belgorod Region, Moscow, Krasnodar Territory, the Republic of Adygea, Voronezh, Primorye Territory, Tatarstan, Lipetsk, Chelyabinsk).
Results. The study revealed an insufficient level of doctors knowledge in diagnosis and treatment of AH. Less than half of the respondents correctly answered the following questions: determining hypertension by the level of home monitoring of BP (36% of physicians), determining the degree of hypertension for the proposed numerical values (37% of physicians), definition and prevalence of the refractory hypertension (33% of physicians), definition of the masked hypertension (45% of physicians), the need for drug correction of high normal BP (9% of physicians), selection of the main classes of antihypertensive drugs without clinical situations (26% of physicians).
Conclusion. The physicians knowledge on AH is unsatisfactory, despite the prevalence of pathology and the availability of clinical guidelines, which, in our view, justifies the need for additional public education programs for doctors in different regions.
Introduction: The irrational use of medicines leads to a decrease in the quality of care, an increase in treatment costs and side effects. In the case of antibacterial drugs, in addition to all the above-mentioned consequences, their improper use can lead to an aggravation of the existing and quite challenging problem of our time – the growth of antibiotic resistance among pathogenic microorganisms.
The aim of the study: to determine the level of basic knowledge of medical specialists in the field of a rational use of antimicrobial drugs (AMD).
Materials and methods: The study was based on an analysis of an anonymous multicenter survey in the framework of the KANT project (the full name of the project is “Physicians’ (Students’) Knowledge of Antimicrobials Usage”). It was conducted in 2018–2019 in 10 major centers of Russia.
Results and iscussion: According to the results of the study, the respondents showed a low level of knowledge of the rational use of antibacterial drugs. The best results are obtained for questions No.1 (time interval for evaluating the effectiveness of the initial antimicrobial therapy (AMT)), No.2 (rationality and period of AMD change with a positive clinical effect), and No.9 (determining the mode of using the proposed drugs), whereas the worst results were obtained for questions No.3 (determining irrational combinations of AMD), No.4 (determining a situation requiring a long course of AMT), and No.7 (choosing auxiliary drugs for bacterial respiratory infections).
Conclusion: The results obtained in the study indicate the need for additional educational activities among health professionals.
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