Abstract
BackgroundThe current prevalence of chronic obstructive pulmonary disease (COPD) in France is estimated to be 2.6 million and is predicted to increase to 2.8 million by 2025. Presently, there is a lack of data on COPD management within the private healthcare setting. The aim of this study was to investigate the management of COPD exacerbations by pulmonologists within private practices in France.MethodsA prospective, online, qualitative survey was distributed to private practice pulmonologists in France. The survey covered all aspects of COPD management from diagnosis and therapeutic management, to secondary prevention and organization of care. Survey responses were collected between 27 January 2018 and 18 June 2018 and all data were summarized descriptively.ResultsThe survey had a response rate of 20.6%, with 116 out of 563 pulmonologists providing responses. Overall, 87.4% of respondents stated that the management of COPD represented over 15% of their total clinical activity. Most respondents indicated that they work closely with general practitioners and a large multidisciplinary team to manage patients with numerous comorbidities. Following a COPD exacerbation, the majority of respondents (78.4%) were in favor of using respiratory-connected devices (class 2a-connected medical device according to the French HAS classification and available on medical prescription) to assist with patient follow-up at home.ConclusionsCOPD management forms part of the core clinical activity for pulmonologists within the private practice setting in France. Patients with COPD generally have multiple comorbidities and are managed by a multidisciplinary team in line with French guidelines. The use of respiratory-connected devices was highlighted as an important new strategy for improving patient care following a COPD exacerbation.
Highlights
Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease characterized by airflow limitation and persistent respiratory symptoms [1]
87.4% of respondents stated that the management of COPD represented over 15% of their total clinical activity
The use of respiratory-connected devices was highlighted as an important new strategy for improving patient care following a COPD exacerbation
Summary
Chronic obstructive pulmonary disease (COPD) is a common, preventable, and treatable disease characterized by airflow limitation and persistent respiratory symptoms [1]. Acute exacerbations negatively impact health status, accelerate lung function decline, and increase mortality risk [1, 5] Overall, they account for more than half the hospitalizations in COPD [5]. The Global initiative for chronic Obstructive Lung Disease (GOLD), Haute Autoritede Sante (HAS) and Societede Pneumologie de Langue Francaise (SPLF) recommend similar approaches for the management of COPD exacerbations. These include bronchodilation (short-acting inhaled β2agonists with or without short-acting anticholinergics), oral corticosteroids, oxygen supplementation, antibiotics (when signs of bacterial infection are present), and non-invasive mechanical ventilation (in patients with acute respiratory failure and no contraindications) [1, 9]
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