Publication: Determinants for changing the treatment of COPD: a regression analysis from a clinical audit.
dc.contributor.author | López-Campos, Jose Luis | |
dc.contributor.author | Abad Arranz, María | |
dc.contributor.author | Calero Acuña, Carmen | |
dc.contributor.author | Romero Valero, Fernando | |
dc.contributor.author | Ayerbe García, Ruth | |
dc.contributor.author | Hidalgo Molina, Antonio | |
dc.contributor.author | Aguilar Perez-Grovas, Ricardo I | |
dc.contributor.author | García Gil, Francisco | |
dc.contributor.author | Casas Maldonado, Francisco | |
dc.contributor.author | Caballero Ballesteros, Laura | |
dc.contributor.author | Sánchez Palop, María | |
dc.contributor.author | Pérez-Tejero, Dolores | |
dc.contributor.author | Segado, Alejandro | |
dc.contributor.author | Calvo Bonachera, Jose | |
dc.contributor.author | Hernández Sierra, Bárbara | |
dc.contributor.author | Doménech, Adolfo | |
dc.contributor.author | Arroyo Varela, Macarena | |
dc.contributor.author | González Vargas, Francisco | |
dc.contributor.author | Cruz Rueda, Juan J | |
dc.contributor.authoraffiliation | [López-Campos,JL; Abad Arranz, M; Calero Acuña,C] Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain. [López-Campos,JL; Calero Acuña,C] Centro de Investigación Biomédica en Red de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. [Romero Valero,F; Hidalgo Molina,A] Hospital Universitario Puerta del Mar, Cádiz, Spain. [Aguilar Perez-Grovas,RI] Hospital Juan Ramón Jiménez, Huelva, Spain. [García Gil,F; Caballero Ballesteros,L] Hospital Universitario Reina Sofía, Córdoba, Spain. [Casas Maldonado,F; Sánchez Palop,M] Hospital Universitario San Cecilio, Granada, Spain. [Pérez-Tejero,D; Segado,A] Hospital Infanta Margarita, Cabra, Córdoba, Spain. [Calvo Bonachera,J; Hernández Sierra,B] Hospital Torrecárdenas, Almería, Spain. [Doménech,A; Arroyo Varela,M] Hospital Regional Universitario de Málaga, Spain. [González Vargas,F; Cruz Rueda,JJ] Hospital Universitario Virgen de las Nieves, Granada, Spain. | es |
dc.contributor.funder | This study was financially supported by an unrestricted grant from Laboratorios Menarini, SA (Barcelona, Spain). | |
dc.date.accessioned | 2016-10-21T08:24:10Z | |
dc.date.available | 2016-10-21T08:24:10Z | |
dc.date.issued | 2016-06-02 | |
dc.description | Journal Article; | es |
dc.description.abstract | INTRODUCTION This study is an analysis of a pilot COPD clinical audit that evaluated adherence to guidelines for patients with COPD in a stable disease phase during a routine visit in specialized secondary care outpatient clinics in order to identify the variables associated with the decision to step-up or step-down pharmacological treatment. METHODS This study was a pilot clinical audit performed at hospital outpatient respiratory clinics in the region of Andalusia, Spain (eight provinces with over eight million inhabitants), in which 20% of centers in the area (catchment population 3,143,086 inhabitants) were invited to participate. Treatment changes were evaluated in terms of the number of prescribed medications and were classified as step-up, step-down, or no change. Three backward stepwise binominal multivariate logistic regression analyses were conducted to evaluate variables associated with stepping up, stepping down, and inhaled corticosteroids discontinuation. RESULTS The present analysis evaluated 565 clinical records (91%) of the complete audit. Of those records, 366 (64.8%) cases saw no change in pharmacological treatment, while 99 patients (17.5%) had an increase in the number of drugs, 55 (9.7%) had a decrease in the number of drugs, and 45 (8.0%) noted a change to other medication for a similar therapeutic scheme. Exacerbations were the main factor in stepping up treatment, as were the symptoms themselves. In contrast, rather than symptoms, doctors used forced expiratory volume in 1 second and previous treatment with long-term antibiotics or inhaled corticosteroids as the key determinants to stepping down treatment. CONCLUSION The majority of doctors did not change the prescription. When changes were made, a number of related factors were noted. Future trials must evaluate whether these therapeutic changes impact clinically relevant outcomes at follow-up. | es |
dc.description.version | Yes | es |
dc.identifier.citation | López-Campos JL, Abad Arranz M, Calero Acuña C, Romero Valero F, Ayerbe García R, Hidalgo Molina A, et al. Determinants for changing the treatment of COPD: a regression analysis from a clinical audit. Int J Chron Obstruct Pulmon Dis. 2016; 11:1171-8 | es |
dc.identifier.doi | 10.2147/COPD.S103614 | |
dc.identifier.essn | 1178-2005 | |
dc.identifier.issn | 1176-9106 | |
dc.identifier.pmc | PMC4898035 | |
dc.identifier.pmid | 27330285 | |
dc.identifier.uri | http://hdl.handle.net/10668/2480 | |
dc.journal.title | International Journal of Chronic Obstructive Pulmonary Disease | |
dc.language.iso | en | |
dc.organization | AGS Sur de Córdoba | |
dc.publisher | Dove Medical Press | es |
dc.relation.publisherversion | https://www.dovepress.com/determinants-for-changing-the-treatment-of-copd-a-regression-analysis--peer-reviewed-article-COPD | es |
dc.rights.accessRights | open access | |
dc.subject | Quality of care | es |
dc.subject | Outpatient care | es |
dc.subject | Treatment strategies | es |
dc.subject | Follow-up | es |
dc.subject | Respiratory diseases | es |
dc.subject | Airway diseases | es |
dc.subject | Andalucía | es |
dc.subject | Atención ambulatoria | es |
dc.subject | Auditoría clínica | es |
dc.subject | Estudios de seguimiento | es |
dc.subject | Volumen espiratorio forzado | es |
dc.subject | Servicio ambulatorio en hospital | es |
dc.subject | Enfermedad pulmonar obstructiva crónica | es |
dc.subject | España | es |
dc.subject | Corticoesteroides | es |
dc.subject | Antibacterianos | es |
dc.subject.mesh | Medical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Services::Patient Care::Ambulatory Care | es |
dc.subject.mesh | Medical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality Assurance, Health Care::Clinical Audit | es |
dc.subject.mesh | Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Cohort Studies::Longitudinal Studies::Follow-Up Studies | es |
dc.subject.mesh | Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Techniques, Respiratory System::Respiratory Function Tests::Pulmonary Ventilation::Forced Expiratory Volume | es |
dc.subject.mesh | Medical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::Ambulatory Care Facilities::Outpatient Clinics, Hospital | es |
dc.subject.mesh | Medical Subject Headings::Diseases::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive | es |
dc.subject.mesh | Medical Subject Headings::Geographicals::Geographic Locations::Europe::Spain | es |
dc.subject.mesh | Medical Subject Headings::Chemicals and Drugs::Hormones, Hormone Substitutes, and Hormone Antagonists::Hormones::Adrenal Cortex Hormones | es |
dc.subject.mesh | Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Anti-Bacterial Agents | es |
dc.title | Determinants for changing the treatment of COPD: a regression analysis from a clinical audit. | es |
dc.type | research article | |
dc.type.hasVersion | VoR | |
dspace.entity.type | Publication |
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