RESUMEN
AIM: Utilizing data from the Continuing to Confront COPD (chronic obstructive pulmonary disease) International Physician Survey, this study aimed to describe physicians' knowledge and application of the GOLD (Global initiative for chronic Obstructive Lung Disease) Global Strategy for the Diagnosis, Management and Prevention of COPD diagnosis and treatment recommendations and compare performance between primary care physicians (PCPs) and respiratory specialists. MATERIALS AND METHODS: Physicians from 12 countries were sampled from in-country professional databases; 1,307 physicians (PCP to respiratory specialist ratio three to one) who regularly consult with COPD, emphysema, or chronic bronchitis patients were interviewed online, by telephone or face to face. Physicians were questioned about COPD risk factors, prognosis, diagnosis, and treatment, including knowledge and application of the GOLD global strategy using patient scenarios. RESULTS: Physicians reported using spirometry routinely (PCPs 82%, respiratory specialists 100%; P<0.001) to diagnose COPD and frequently included validated patient-reported outcome measures (PCPs 67%, respiratory specialists 81%; P<0.001). Respiratory specialists were more likely than PCPs to report awareness of the GOLD global strategy (93% versus 58%, P<0.001); however, when presented with patient scenarios, they did not always perform better than PCPs with regard to recommending GOLD-concordant treatment options. The proportion of PCPs and respiratory specialists providing first- or second-choice treatment options concordant with GOLD strategy for a GOLD B-type patient was 38% versus 67%, respectively. For GOLD C and D-type patients, the concordant proportions for PCPs and respiratory specialists were 40% versus 38%, and 57% versus 58%, respectively. CONCLUSION: This survey of physicians in 12 countries practicing in the primary care and respiratory specialty settings showed high awareness of COPD-management guidelines. Frequent use of guideline-recommended COPD diagnostic practices was reported; however, gaps in the application of COPD-treatment recommendations were observed, warranting further evaluation to understand potential barriers to adopt guideline recommendations.
Asunto(s)
Adhesión a Directriz/tendencias , Conocimientos, Actitudes y Práctica en Salud , Guías de Práctica Clínica como Asunto , Pautas de la Práctica en Medicina/tendencias , Enfermedad Pulmonar Obstructiva Crónica/terapia , Actitud del Personal de Salud , Concienciación , Brasil , Europa (Continente) , Femenino , Adhesión a Directriz/normas , Encuestas de Atención de la Salud , Humanos , Japón , Masculino , México , Médicos de Atención Primaria/tendencias , Guías de Práctica Clínica como Asunto/normas , Pautas de la Práctica en Medicina/normas , Pronóstico , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Enfermedad Pulmonar Obstructiva Crónica/etiología , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Neumología/tendencias , República de Corea , Factores de Riesgo , Especialización/tendencias , Encuestas y Cuestionarios , Estados UnidosAsunto(s)
Empleo/tendencias , Pediatría/tendencias , Neumología/tendencias , Adulto , Anciano , Selección de Profesión , Certificación , Niño , Femenino , Humanos , Masculino , Medicina , Persona de Mediana Edad , Especialización , Estados UnidosRESUMEN
La neumología en México perdió terreno en las últimas décadas, en relación a otras especialidades, primordialmentes por una deficiente formación de recursos humanos. Para revertir la tendencia, por tanto, se requiere preparar neumólogos de excelencia, proceso que va consolidándose, por lo que se prevee un futuro halagador