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Characterization of secondary care for COPD in Sweden
Örebro University, School of Medical Sciences. Orebro University Hospital. Department of Respiratory Medicine.
Department of Medical Sciences: Respiratory; Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
Department of Public Health and Caring Science, Family Medicine and Preventive Medicine, Uppsala University, Uppsala, Sweden.
Unit for Lung and Airway Research, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.
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2017 (English)In: European Clinical Respiratory Journal, E-ISSN 2001-8525, Vol. 4, 1-8 p.Article in journal (Refereed) Published
Abstract [en]

Introduction: Only a selected proportion of chronic obstructive pulmonary disease (COPD) patients are managed in secondary care. The aim of this study was to characterize disease severity, treatment and structure of secondary care for COPD in Sweden.

Methods: Information was collected from 29 of 33 existing secondary care units of respiratory medicine in Sweden, using both individual data from 373 consecutively enrolled COPD patients with Global initiative on Obstructive Lung Disease (GOLD) stage III-IV and a structural questionnaire about available resources at the units. Patient data included exacerbations, health status assessed by COPD Assessment Test (CAT), lung function, comorbid conditions, pharmacological treatment and vaccinations. Structural data included available smoking cessation support, multi-disciplinary rehabilitation, physical training, patient education and routine follow-up after exacerbations at the respective unit. All patients were reclassified according to the GOLD 2014 group AD classification. Multiple linear regression investigated associations of available resources with number of exacerbations and CAT score.

Results: According to GOLD 2014, 87% of the population were GOLD D and 13% were GOLD C. Triple inhaled therapy were prescribed in 88% of the patients. Over 75% of the units had resources for smoking cessation, multidisciplinary rehabilitation, physical training and patient education. Routine follow-up after exacerbations was available in 35% of the units. Being managed at units with access to structured patient education was associated with statistically significantly fewer exacerbations (adjusted regression coefficient (95% confidence interval) -0.79 (-1.39 to -0.19), p = 0.010).

Conclusion: Most stage III-IV COPD patients managed at secondary care respiratory units in Sweden have maximized inhaled therapy and high risk disease even when reclassified according to GOLD 2014. Most units have access to smoking cessation, rehabilitation and patient education. Patients managed at units with structured patient education have a lower exacerbation risk.

Place, publisher, year, edition, pages
Taylor & Francis, 2017. Vol. 4, 1-8 p.
Keyword [en]
GOLD classification, pharmacological therapy, structural resources, patient education
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:oru:diva-56926DOI: 10.1080/20018525.2016.1270079ISI: 000397130600001OAI: oai:DiVA.org:oru-56926DiVA: diva2:1086859
Note

Funding Agency:

Region Örebro County through ALF

Available from: 2017-04-04 Created: 2017-04-04 Last updated: 2017-04-04Bibliographically approved

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CiteExportLink to record
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Citation style
  • apa
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