Clinical characteristics of patients with chronic obstructive pulmonary disease treated in pulmonology departments in the Kazan city

Chronic obstructive pulmonary disease (COPD) remains a disease which prevalence in the world is not decreasing, and mortality is increasing. Over the past 10 years, the recommendations for the classification and treatment of COPD have changed many times. The aim of the work was assessing the condition of patients with COPD and the features of their treatment in pulmonology departments of Kazan. Material and Methods. Sixty patients with COPD were examined in a hospital - 59 (98.3%) men and 1 (1.7%) woman, whose average age was 63.8±1.0 years. All patients underwent a physical examination, a survey was conducted on standardized CAT and mMRC questionnaires, and a spirogram of forced expiration was recorded. Result. According to the GOLD 2007 classification, the patients were distributed in the following way: GOLD I - in 5%, GOLDII - 20%, GOLDIII - 51.7% GOLDIV - 23.3%. According to ABCD classification, GOLD 2017 to subgroup C was assigned 1 patient and 59 - to subgroup D. Completely compliant were 28.3% of patients, 65% of patients were well trained by the paramedic for correctly use of their inhalers. Patients preferred short-acting bronchodilators and metered-dose aerosol inhalers among all drugs, they would like to use them only as required. 25% of patients received long-acting beta-adrenoceptor agonist in combination with short-acting drugs, 23.3% of patients mixed a combination of an inhaled steroid with a long-acting bronchodilator and a short-acting bronchodilator as needed, 20% inhaled two long-acting bronchodilators. Conclusion. The study revealed a discrepancy between actual practice and clinical recommendations. The authors linked it with the training of doctors once in 5 years, whereas the recommendations were updated annually. It was suggested that the compliance of patients and their commitment to long-acting bronchodilators would increase with the widespread use of drugs with a rapid start of action.

chronic obstructive pulmonary disease, treatment, clinical guidelines, bronchodilators