Knowledge about COPD among users of primary health care services

Awareness of chronic obstructive pulmonary disease (COPD) among the general population in Aseer Region, Kingdom of Saudi Arabia (KSA)

Background

Chronic obstructive pulmonary disease (COPD) is a common but preventable disease and has a prevalence of 5%-14% in the general population. It is characterized by airflow limitation and persistent respiratory symptoms. In this survey, we aimed to assess the awareness of COPD among the general population in the Aseer Region of the Kingdom of Saudi Arabia (KSA).

Method

This was an observational, cross-sectional study in which predesigned electronic questionnaires were distributed to 504 randomly selected community personnel utilizing phone services. The collected data were analyzed using the IBM SPSS Statistics software, version 24 for Windows (IBM Corp., Armonk, NY).

Results

Participants were asked 11 questions with yes-or-no answers based on awareness and symptoms of COPD: 35.5% of participants had heard about the COPD as a term and 72% had no detailed information about COPD. Only 3.5% of participants had relatives with COPD. During the survey on COPD symptoms, 31% of participants chose shortness of breath and the rest chose cough (20%), sputum production (15%), wheezing (14%), and chest pain (19%). Almost two-third of the participants had no idea about COPD symptoms. For the most disease knowledge, majority of the study participants had very poor knowledge about the disease that was evident in the 22 questions intended to assess this domain. Social media sites ranked as the most popular source of information on COPD among the study participants.

Conclusion

Awareness about COPD among the general population in the Aseer Region in KSA is poor. It is advisable to carry out programs to increase their level of awareness.

Multidisciplinary education with a focus on COPD in primary health care

OBJECTIVE

To evaluate the use of video lessons on the topic of COPD as a training tool for a multidisciplinary team working in the primary health care sector.

METHODS

This was a quasi-experimental study involving a multidisciplinary team working at a primary health care clinic. The level of knowledge about COPD was measured by applying a specific, 16-item questionnaire - before, immediately after, and three months after the video lessons. In a set of six structured video lessons, the training focused on the prevention, case-finding, treatment, and monitoring of cases of COPD. The data were analyzed with the Friedman test, the Kruskal-Wallis test, Tukey's post hoc test, Dunnett's test, and the Bonferroni test.

RESULTS

There was a significant difference between the periods before and immediately after the training in terms of the scores on 15 of the 16 items on the questionnaire regarding the level of knowledge about COPD. The median total score of the participants increased significantly, from 60 points before the training to 77 points immediately thereafter and 3 months thereafter (p < 0.001 for both). Before the training, 23 (63.9%) and 13 (36.1%) of the members of the multidisciplinary team presented strong and very strong levels of agreement, respectively, among the 16 questionnaire items. After the training, 100% of the individuals presented a very strong degree of agreement.

CONCLUSIONS

Multidisciplinary education through video lessons increased the knowledge of COPD on the part of a primary health care team, and the knowledge acquired was retained for at least three months after the intervention.

Comparative assessment of physicians’ and senior medical students’ basic knowledge in treatment of chronic obstructive pulmonary disease

Introduction: Chronic obstructive pulmonary disease (COPD) is one of the most common pathologies of the respiratory system. This disease ranks third in the group of the main causes of death in the world. The effective treatment of COPD has been developed by today. However, a significant part of physicians has an insufficient amount of education in this matter.

Materials and methods: The article represents the results of anonymous prospective survey within the ASCO project (full title – “Assessment of Senior Medical Students in the Field of COPD”), aimed at assessing the basic knowledge in the COPD treatment. The survey involved 321 physicians and 221 senior medical students from ten cities of Russia and Ukraine.

Results and discussion: According to the survey, the following levels of correct answers were given by the doctors and students: possible fixed combinations of β2-agonist – 33.9% and 24.5%; the optimal delivery device for a patient – 50.8% and 41.8; the correct drugs for COPD initial therapy with a high risk of exacerbations – 31.7% and 15.3%, and with a low risk – 54.9% and 25.9%, respectively. The correct drugs for COPD aggravation were selected by 43.3% of doctors and 34.5% of students; the right empirical treatment of COPD infectious exacerbation – by 72.4% and 40%, and the correct reserve drugs – by 63.9% and 36.2%, respectively.

Conclusion: The survey showed that the respondents had medium level of knowledge in COPD treatment. Hence, curricula need to be adjusted in medical universities, and additional educational activities are required for medical practitioners in order to improve the quality of their knowledge in this field.

[Being diagnosed with COPD: A qualitative study of real life experience]

INTRODUCTION

This qualitative study aimed to explore the real life experience of the patients with chronic obstructive pulmonary disease (COPD) at the time they receive the diagnosis.

METHODS

Data were collected using face to face interviews in general practice as well as focus groups in a pulmonary rehabilitation centre.

RESULTS

Thirty-four patients participated in the study. Most of them were made aware of their disease by a pulmonologist during hospitalisation for an acute exacerbation. Several terms were used to name the disease including emphysema, asthma, chronic bronchitis and COPD (acronym often not explained). At the time of the announcement, patients expressed responses which included for some a sense of stupefaction associated with anxiety and for others guilt and an attitude of denial. If the need for smoking cessation was mentioned by doctors, a lack of information at the time of the announcement was general. The chronic and potentially serious aspects of COPD were not understood or rarely mentioned.

CONCLUSION

The announcement of the disease did not always appear to have been of good quality. Ideally, the diagnosis of COPD should be conveyed to people after its identification in a dedicated consultation, combined with better information and a proposal for psychological support.

Understanding of COPD among final-year medical students

Objective

Several previous studies have shown a suboptimal level of understanding of COPD among different population groups. Students in their final year of Medicine constitute a population that has yet to be explored. The evaluation of their understanding provides an opportunity to establish strategies to improve teaching processes. The objective of the present study is to determine the current level of understanding of COPD among said population.

Methods

A cross-sectional observational study was done using digital surveys given to medical students in their final year at the Universidad de Sevilla. Those surveyed were asked about demographic data, smoking habits as well as the clinical manifestation, diagnosis and treatment of COPD.

Results

Of the 338 students contacted, responses were collected from 211 of them (62.4%). Only 25.2% had an accurate idea about the concept of the disease. The study found that 24.0% of students were familiar with the three main symptoms of COPD. Tobacco use was not considered a main risk factor for COPD by 1.5% of students. Of those surveyed, 22.8% did not know how to spirometrically diagnose COPD. Inhaled corticosteroids were believed to be part of the main treatment for this disease among 51.0% of the students. Results show that 36.4% of respondents believed that home oxygen therapy does not help COPD patients live longer. Only 15.0% considered the Body-mass index, airflow Obstruction, Dyspnea, and Exercise (BODE) index to be an important parameter for measuring the severity of COPD. Giving up smoking was not believed to prevent worsening COPD among 3.4% of students surveyed. Almost half of students (47.1%) did not recommend that those suffering from COPD undertake exercise.

Conclusion

The moderate level of understanding among the population of medical students in their final year shows some strengths and some shortcomings. Teaching intervention is required to reinforce solid knowledge among this population.

Risk factors for FEV1 decline in mild COPD and high-risk populations

Background

Early diagnosis of COPD is often not achieved due to limited recognition and limited access to the pulmonary function test. Our hypothesis was that lung function decline may be different between populations with mild COPD and those who are at high risk and do not receive treatment.

Patients and methods

Subjects with mild COPD and those from a high-risk COPD population were recruited from a community-based COPD epidemiological study after obtaining consent. Baseline clinical characteristics, symptom questionnaire, spirometry, low-dose computed tomography (LDCT) chest scan, and blood plasma biomarker data were collected initially and then 1 year later.

Results

A total of 617 participants were recruited, and 438 eventually completed the first-year follow-up visit; 72 participants (46 males) were in the mild COPD group, and 225 participants (165 males) were in the high-risk group. The mean forced expiratory volume in the first second of expiration (FEV₁) decline in the mild COPD group was 129 mL, which was significantly higher than the 30 mL decline in the high-risk population group (P=0.005). Group category (odds ratio [OR] =0.230) and COPD Assessment Test (CAT) score (OR =9.912) were independent risk factors for an FEV₁% predicted decline of >15% for all participants. In the mild COPD group, patients with a higher CAT (OR =5.310) and Emphysema Index (OR =5.681) were associated with a FEV₁% predicted decline of >15% at the first-year follow-up. No factor showed a significantly predictive effect on FEV₁ decline in the high-risk COPD group.

Conclusion

Group category was an independent influential factor associated with FEV₁ decline.

How do patients conceptualize chronic obstructive pulmonary disease?

Chronic obstructive pulmonary disease (COPD) is a leading cause of death in the United States, yet even at risk or diagnosed patients misunderstand COPD and its consequences for their quality of life and mortality. This study explored how patients conceptualize the causes, symptoms, consequences, treatment, and risk for developing COPD. The study consisted of six focus groups: 39 participants who were adults > 40 and current smoker or have COPD symptoms, family history, or exposures. Although many participants had some familiarity with the breathing, lung function, physical, emotional, and social consequences of COPD, confusion and misunderstanding prevailed. Few knew that COPD, chronic bronchitis, and emphysema are synonymous. Some participants claimed that they "only" had bronchitis and/or emphysema and not COPD. Some participants described behavioral adaptations to decrease symptom impact and others expressed strong interest in learning how to increase daily functioning. Insufficient knowledge and persisting misconceptions about COPD can prevent patients from accessing life-enhancing strategies. Patients can benefit from (1) providers clarifying COPD's connection to chronic bronchitis and emphysema to aid them in recognizing the need for mitigating action; (2) encouraging smoking cessation, specifically to stem worsening of disease; and (3) explaining lifestyle adaptations for easing daily life despite decreased lung function.