Different Valuations of COPD Treatment Goals Between General Practitioners and Pulmonology Specialists in a Real-World Evidence Study From Romania (ACORD)

Abstract

SESSION TITLE: Quality Improvement 2 SESSION TYPE: Original Investigation Poster PRESENTED ON: Wednesday, November 1, 2017 at 01:30 PM - 02:30 PM PURPOSE: Chronic obstructive pulmonary disease (COPD) is a progressive disease with poor clinical outcomes if not appropriately treated. General practitioners (GPs) and pulmonology specialists are the pillars of the COPD care team. Little is known about the way the Romanian GPs and pulmonologists value the COPD treatment goals. The study ACORD aimed to evaluate the concordance of treatment goals between patients and physicians in COPD management in Romania and included both GPs and pulmonologists. We will present here the results for the two groups of physicians. METHODS: ACORD (The Assessment of the Concordance of the Treatment Goals in COPD between Patients and Physicians) was a real-world evidence study. Based on literature review and discussion with national experts, fourteen goals of COPD treatment have been identified and included in one questionnaire. Participants were asked to rate each treatment goal on a scale from 1 to 9 (1 = the smallest importance, 9 = the highest importance) and to rank the same treatment goals based on personal valuation in a top from 1 to 5, where 1 is the most important attribute. Scores were calculated based on rating and ranking, and Student and Mann-Whitney-Wilcoxon tests applied. RESULTS: An equal number (n=199) of GPs [50 (25.1%) male, mean age (SD) 55.62 (10.01) years] and pulmonologists [38 (19.1%) male, mean age (SD) 46.47 (8.47) years)] participated in ACORD study. For GPs, the most valued goals by rating were improvement of health status (8.56), symptoms improvement (8.54) and treatment safety (8.40), while by ranking these were equally health status and symptoms improvement (2.4) and prevention of disease progression (1.8). For pulmonologists, the most valued goals by rating were prevention and treatment of exacerbations (8.78), symptoms improvement (8.64) and treatment safety (8.58), while by ranking these were symptoms improvement (2.8), and prevention and treatment of exacerbations (2.5). The responses were significantly different for 9 out of 14 treatment goals (with p£0.05 and p£0.001). CONCLUSIONS: The opinions and valuations of two different categories of physicians involved in COPD management were different. Symptoms improvement and treatment safety were among the most valued goals for both categories, but GPs seemed more preoccupied by general health status improvement and prevention of COPD progression, while the pulmonologists valued more prevention and treatment of exacerbations. CLINICAL IMPLICATIONS: This study provided insights about the importance of treatment goals in COPD management as perceived by GPs and pulmonologists. The differences between the two categories of physicians indicate the existence of different definitions of disease and treatment that may be explained by status and role categories and should be further investigated for a better patient shared care. DISCLOSURE: Ruxandra Ulmeanu: Consultant fee, speaker bureau, advisory committee, etc.: speaker's fees, clinical studies, and congress fees Florin Mihaltan: Consultant fee, speaker bureau, advisory committee, etc.: speaker's fees, clinical studies, and congress fees Oana Arghir: Consultant fee, speaker bureau, advisory committee, etc.: speaker's fees, clinical studies, and congress fees Ovidiu Mladinescu: Consultant fee, speaker bureau, advisory committee, etc.: speaker's fees, clinical studies, and congress fees Gabriela Teodorescu: Employee: employee No Product/Research Disclosure Information