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Management of COPD in general practice in Denmark – participating in an educational program substantially improves adherence to guidelines

BACKGROUND AND AIM: The general practitioner (GP) is the first contact with the health care system for most patients with COPD in Denmark. We studied, if participating in an educational program could improve adherence to guidelines, not least for diagnosis, staging, and treatment of the disease. DES...

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Autores principales: Ulrik, Charlotte Suppli, Hansen, Ejvind Frausing, Jensen, Michael Skov, Rasmussen, Finn Vejlø, Dollerup, Jens, Hansen, Gert, Andersen, Klaus Kaae
Formato: Texto
Lenguaje:English
Publicado: Dove Medical Press 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2865027/
https://www.ncbi.nlm.nih.gov/pubmed/20463948
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author Ulrik, Charlotte Suppli
Hansen, Ejvind Frausing
Jensen, Michael Skov
Rasmussen, Finn Vejlø
Dollerup, Jens
Hansen, Gert
Andersen, Klaus Kaae
author_facet Ulrik, Charlotte Suppli
Hansen, Ejvind Frausing
Jensen, Michael Skov
Rasmussen, Finn Vejlø
Dollerup, Jens
Hansen, Gert
Andersen, Klaus Kaae
author_sort Ulrik, Charlotte Suppli
collection PubMed
description BACKGROUND AND AIM: The general practitioner (GP) is the first contact with the health care system for most patients with COPD in Denmark. We studied, if participating in an educational program could improve adherence to guidelines, not least for diagnosis, staging, and treatment of the disease. DESIGN AND SETTING: Two cross-sectional surveys were performed precisely one year apart before and after an educational program for the participating GPs. A total of 124 GPs completed the study; 1716 and 1342 patients with GP-diagnosed COPD and no concomitant asthma, respectively, were included in the two surveys. RESULTS: The proportion of patients having FEV(1) registered in the GPs files increased from 45% to 69% (P < 0.001); and, furthermore, FEV(1) % of predicted was recorded in 30% and 56%, respectively, of the cases (P < 0.001). In line with this, significant improvements were also observed for registration of smoking status (69% to 85%), BMI (8% to 40%), severity of dyspnea (Medical Research Council) (7% to 38%), and FEV(1)/FVC ratio (28% to 58%) (P < 0.001). Concerning the management options, improvements were also observed with regard to antismoking counseling, inhalator technique, physical activity, and referral for rehabilitation; use of inhaled corticosteroids in patients with mild COPD (FEV(1) > 80%pred) declined from 76% to 45%. CONCLUSION: Diagnosis and management of COPD in general practice in Denmark is not according to guidelines, but substantial improvements can be achieved by focused education of GPs and their staff.
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spelling pubmed-28650272010-05-12 Management of COPD in general practice in Denmark – participating in an educational program substantially improves adherence to guidelines Ulrik, Charlotte Suppli Hansen, Ejvind Frausing Jensen, Michael Skov Rasmussen, Finn Vejlø Dollerup, Jens Hansen, Gert Andersen, Klaus Kaae Int J Chron Obstruct Pulmon Dis Original Research BACKGROUND AND AIM: The general practitioner (GP) is the first contact with the health care system for most patients with COPD in Denmark. We studied, if participating in an educational program could improve adherence to guidelines, not least for diagnosis, staging, and treatment of the disease. DESIGN AND SETTING: Two cross-sectional surveys were performed precisely one year apart before and after an educational program for the participating GPs. A total of 124 GPs completed the study; 1716 and 1342 patients with GP-diagnosed COPD and no concomitant asthma, respectively, were included in the two surveys. RESULTS: The proportion of patients having FEV(1) registered in the GPs files increased from 45% to 69% (P < 0.001); and, furthermore, FEV(1) % of predicted was recorded in 30% and 56%, respectively, of the cases (P < 0.001). In line with this, significant improvements were also observed for registration of smoking status (69% to 85%), BMI (8% to 40%), severity of dyspnea (Medical Research Council) (7% to 38%), and FEV(1)/FVC ratio (28% to 58%) (P < 0.001). Concerning the management options, improvements were also observed with regard to antismoking counseling, inhalator technique, physical activity, and referral for rehabilitation; use of inhaled corticosteroids in patients with mild COPD (FEV(1) > 80%pred) declined from 76% to 45%. CONCLUSION: Diagnosis and management of COPD in general practice in Denmark is not according to guidelines, but substantial improvements can be achieved by focused education of GPs and their staff. Dove Medical Press 2010 2010-04-07 /pmc/articles/PMC2865027/ /pubmed/20463948 Text en © 2010 Suppli Ulrik et al, publisher and licensee Dove Medical Press Ltd. This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.
spellingShingle Original Research
Ulrik, Charlotte Suppli
Hansen, Ejvind Frausing
Jensen, Michael Skov
Rasmussen, Finn Vejlø
Dollerup, Jens
Hansen, Gert
Andersen, Klaus Kaae
Management of COPD in general practice in Denmark – participating in an educational program substantially improves adherence to guidelines
title Management of COPD in general practice in Denmark – participating in an educational program substantially improves adherence to guidelines
title_full Management of COPD in general practice in Denmark – participating in an educational program substantially improves adherence to guidelines
title_fullStr Management of COPD in general practice in Denmark – participating in an educational program substantially improves adherence to guidelines
title_full_unstemmed Management of COPD in general practice in Denmark – participating in an educational program substantially improves adherence to guidelines
title_short Management of COPD in general practice in Denmark – participating in an educational program substantially improves adherence to guidelines
title_sort management of copd in general practice in denmark – participating in an educational program substantially improves adherence to guidelines
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2865027/
https://www.ncbi.nlm.nih.gov/pubmed/20463948
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