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Kocks J, Ferreira AJ, Bakke P, van Schayck OCP, Ekroos H, Tzanakis N, Soulard S, Haaksma-Herczegh M, Mestres-Simon M, Águila-Fuentes M, Cataldo D. Investigating the rationale for COPD maintenance therapy prescription across Europe, findings from a multi-country study. NPJ Prim Care Respir Med 2023; 33:18. [PMID: 37137900 PMCID: PMC10154184 DOI: 10.1038/s41533-023-00334-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 02/20/2023] [Indexed: 05/05/2023] Open
Abstract
This study aims to understand healthcare professionals' thoughts and motivations about optimal management and treatment of patients with chronic obstructive pulmonary disease (COPD). We conducted a DELPHI survey through an online questionnaire distributed to 220 panellists from six European countries and a discrete choice experiment to describe the relationship between selected clinical criteria and the initial COPD treatment of choice. One hundred twenty-seven panellists (general practitioners [GPs] and pulmonologists) completed the survey. Despite the familiarity and use (89.8%) of the GOLD classification for initial treatment selection, a frequent use of LAMA/LABA/ICS was noted. In fact, panellists agreed that inhaled corticosteroids (ICS) are over-prescribed in the primary care setting. Our study showed that GPs felt less confident than pulmonologists with ICS withdrawal. This mismatch observed between best practice and behaviour indicates the need to increase awareness and efforts to improve the adherence to guidelines in clinical practice.
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Affiliation(s)
- Janwillem Kocks
- General Practitioners Research Institute, Groningen, The Netherlands.
- Observational and Pragmatic Research Institute, Singapore, Singapore.
- Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
- Department of Pulmonology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
| | - António Jorge Ferreira
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Pulmonology Department, Coimbra Hospital and University Centre, Coimbra, Portugal
| | - Per Bakke
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Onno C P van Schayck
- Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
| | - Heikki Ekroos
- Department of Pulmonary Medicine, Porvoo Hospital, Porvoo, Finland
| | - Nikolaos Tzanakis
- Department of Thoracic Medicine, University Hospital of Heraklion, Medical School, University of Crete, Crete, Greece
| | | | | | | | | | - Didier Cataldo
- Department of Respiratory Medicine, Centre Hospitalier Universitaire de Liège (CHU) and University of Liège, Liège, Belgium
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