Please use this identifier to cite or link to this item: https://www.um.edu.mt/library/oar/handle/123456789/58991
Title: An audit of the management of Chronic Obstructive Pulmonary Disease (COPD) patients in an outpatient setting : looking beyond the respiratory illness
Authors: Mintoff, Malcolm
Caruana Montaldo, Brendan
Azzopardi, Joelle
Keywords: Lungs -- Diseases, Obstructive -- Treatment
Lungs -- Diseases, Obstructive -- Patients -- Home care
Lungs -- Diseases, Obstructive -- Malta -- Case studies
Lungs -- Diseases, Obstructive -- Patients -- Rehabilitation
Issue Date: 2020-07
Publisher: University of Malta. Medical School
Citation: Mintoff, M., Caruana Montaldo, B., & Azzopardi, J. (2020). An audit of the management of Chronic Obstructive Pulmonary Disease (COPD) patients in an outpatient setting : looking beyond the respiratory illness. Malta Medical Journal, 32(1), 27-35.
Abstract: Background: COPD is a major public health concern due to its associated morbidity and mortality, most of which is respiratory-related. However, a number of associated conditions exist, which independently contribute to morbidity and mortality, and therefore must be recognised and treated. The aim was to study the quality of management of outpatients with COPD, analyse whether associated comorbidities were being identified and treated, and if not, establish more effective ways of recognising missed opportunities. -- Methods: This retrospective study examined 37 out-patients with COPD seen by one respiratory firm in a Maltese tertiary centre. Out-patients were randomly selected between 2013 and 2015. The inclusion criterion was a post-bronchodilator FEV1/FVC ratio of <0.7 measured during their most recent spirometry. Outcome measures included an accurate diagnosis of COPD; documentation of smoking history and smoking cessation; appropriate COPD treatment including inhaler technique and assessment of non-adherence; appropriate prescription and usage of oxygen; referral to pulmonary rehabilitation; vaccination status; and consideration of comorbidities. -- Results: 90% were male, mean age 68.5 years, and had all been correctly diagnosed with COPD, while 22% had a related comorbidity. The majority (81%) were ex-smokers. Virtually all were on inhaled bronchodilators, with 60% also on an inhaled corticosteroid. The uptake of Influenza and Pneumococcal vaccination was at 62% and 54% respectively. Only 24% of patients were given physical activity advice or referral to a pulmonary rehabilitation programme. -- Conclusion: The investigators analysed whether practices are in-keeping with the recommended international guidelines. A number of practices were adequate, while others needed improvement. In order to narrow this discrepancy, the investigators suggest creating a template for COPD patients to be used at future visits which includes the factors investigated.
URI: https://www.um.edu.mt/library/oar/handle/123456789/58991
Appears in Collections:MMJ, Volume 32, Issue 1
MMJ, Volume 32, Issue 1
Scholarly Works - FacM&SMed

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