Características de la rehabilitación respiratoria: resultados de una auditoría nacional

Diago, Carlos Antonio Amado; Merchán, Ángel Julián Iglesias; Sayago, Itxaso; Chic, Susana; Gómez, Alba

doi:10.1016/j.opresp.2022.100221

Cited by 1 publication

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References 17 publications

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“…However, it should be noted that 85% of uncontrolled patients had dyspnoea greater than or equal to 2 MRC-m and a CAT greater than 10 and less than 20% had undergone a respiratory rehabilitation program. These ndings could be partly explained by the fact that the prescription of respiratory rehabilitation is still a very limited practice in many centers in Spain, where only 52.4% of the centers surveyed have a dedicated professional to offering this therapy, and 38.1% of the centers include less than 5 patients per month 22 . Another factor associated with clinical inertia that was identi ed in our analysis is the presence of anxiety in the uncontrolled patient, which was present in 15%.…”

Section: Discussionmentioning

confidence: 99%

Clinical control in COPD and therapeutic implications: The EPOCONSUL audit

Rubio,

Miravitlles,

Soler-Cataluña

et al. 2024

Preprint

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Objective: The aim of the study was to evaluate the clinical control in chronic obstructive pulmonary disease (COPD), the consequences in terms of treatment decisions and their potentially associated factors during follow-up of patients in real-life clinical practice. Methods: EPOCONSUL 2021 is a cross-sectional audit that evaluated the outpatient care provided to patients with a diagnosis of COPD in respiratory clinics in Spain and multivariable logistic regression models was performed to assess the relationships between clinical control and clinical inertia. Results: 4225 patients from 45 hospitals in Spain were audited. In 1804 (42.7%) patients were analysed clinical control for having all the GesEPOC criteria. 49.1% of patients were classified as uncontrolled, and of them, in 42.2% there was a disagreement with the doctor's perception, which was reported in visit as good control. There was therapeutic inertia (TI), not taking any change or action in the treatment of COPD, in 68.4% of uncontrolled patients and in 9.1% uncontrolled patients not taking any action was made at the visit. Factors associated with TI in uncontrolled patients were there is disagreement in the degree of control reported by the doctor who performed the visit [Physician's perception is controlled versus uncontrolled, OR: 3.37 (2.33- 4.88), p<0.001] and having a lower burden of associated comorbidities [Charlson comorbidity index ≥3 versus <3, OR 0.8 (0.1–3.0), p=0.014]. The probability of a doctor having a disagreement in the perception in uncontrolled patients was lower in patients with severe exacerbations [OR 0.3 (0.17 – 0.78), p=0.009] or with more exacerbations in the last year [OR 0.6 (9.4 – 0.9), p=0.019]. Uncontrolled patients in whom their physician's perceived control was referred to as good are 2.7 less likely to receive a therapeutic action at the visit, and 4.7 more likely to be scheduled for a longer check-up. Conclusions: Therapeutic inertia exists in more than half of uncontrolled patients and is more likely when there was disagreement with the criteria of the physician responsible for the visit who reported that there was good control, this being more likely in the patient with less history of exacerbations.

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Section: Discussionmentioning

confidence: 99%