Opšta Medicina (Jan 2019)
Approach to the shronic obstructive pulmonarydisease (COPD) patient in general medicine
Abstract
Introduction: Chronic obstructive pulmonary disease (COPD) is a chronic disease and it is estimated 20%-25% of patients remain undiagnosed. Objective: Review the approach of the general practitioner to diagnosing and treatment of COPD. Method: The study was conducted using the questionnaire, among the doctors who attended the Conference “General Medicine Days” that took place in Belgrade, from March 25th to March 26th, 2017. Data on age, gender, years of service, job location (town/village) and specialties: general practitioner (GP) or General Medicine Specialist (GMS) were obtained. Statistical processing was done in the SPSS 11.0 for Windows program. Results: The study included 330 physicians of both genders (88.68% women), average age 49.74 ± 10.5 years and years of service of 21.23 ± 10.55 years; 53.94% were GMS, and 87.27% of doctors worked in outpatient clinics in the city. The definition of COPD was knowledgeable to 74.85% of the participants and the clinical symptoms were recognized by 64.12% of the examined doctors. GPs gave more accurate answers than GMS (p=0.04), as well as doctors with up to 10 years of services (p=0.04), 81.46%, confirmed that bronco obstruction should be confirmed with spirometry, more doctors with up to 10 years of service (p=0.01). 46.38% of the examined doctors think spirometry could be performed at the PHC level. The spirometry finding are interpreted correctly by 61.7% of doctors. The pulmonary oximeter device owns 29.43% of doctors in their clinics, more often GPs (p=0.02) and doctors working in the rural clinics (p=0.02). 56% of doctors have an inhaler and use it regularly, more often doctors in rural outpatient clinics (p=0.02). For 56.56% of doctors, smoking cessation is the first step in COPD treatment. 78.12% think the therapy should be increased stepwise, and 55.32% of them self-initiated bronchodilator therapy (more often doctors with a years of practice of over 20 years, p=0.01). Conclusion: It is necessary to change the doctors` attitude in general practice towards COPD and to improve knowledge about diagnostics and therapy.
