Prevalence of Risk Factors and Pharmacotherapeutic Management of COPD in Elderly Patients

Abstract

Chronic obstructive pulmonary disease (COPD) is the most common illness in the elderly population. Treating elderly patients is a challenge for physicians because of the co-existence of multi-morbidities, which increases the number of prescribed medications among these patients. The objectives of this study were to identify prevalence of associated risk factors and to evaluate pharmacotherapeutic management of COPD in elderly patients. A prospective, observational study was conducted from January 2019 to December 2019 in the department of pulmonary medicine of a tertiary care teaching hospital in Bangalore, India. A total of 136 elderly patients diagnosed with COPD aged above 65 years who consented to take part in the study and fulfilled study criteria were enrolled. A well designed and internally validated case report form was used to document the findings after a due approval obtained from the Institutional Ethics Committee. Socio-demographic characteristics, prescribed medications, risk factor and clinical characteristics were documented and analyzed. Out of 136 elderly patients, 52.21% were male while 47.79% were female. The mean age of the participants was 70.68±5.08 (SD) years. Amongst the study patients 48.53% had other comorbidities. The major risk factors associated with COPD were smoking (38.97%), biomass fuel exposure (16.91%) and occupational exposure (36.76%). Treatment with antibiotic combination therapy was observed in 48.53% of patients, 46.32% with antibiotic monotherapy followed by 4.41% with escalation of therapy. It is evident from this study that the prevalence of risk factors such as age, cigarette smoking, exposure to biomass smoke and occupation plays a role in the development of COPD and it requires a rational approach in the management of COPD in the elderly patients.