Evaluating Adherence to the 2023 Canadian Thoracic Society Chronic Obstructive Pulmonary Disease Pharmacotherapy Guidelines: A Hospital-Based Study.

Background: A previous study at Montfort Hospital (Ottawa, Ontario, Canada) found that only one-fifth of patients treated in 2022 for a severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD) were prescribed the appropriate inhaled therapy at discharge. The revised 2023 Canadian...

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Publicado en:Therapeutic Advances in Pulmonary & Critical Care Medicine pp. 1 - 7
Autor principal: Saint-Pierre, Mathieu D.
Formato: research tables/charts Journal Article
Publicado: Sage Publications Inc. 4/30/2025
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 4/30/2025
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      pub: Sage Publications Inc.
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        atl: Evaluating Adherence to the 2023 Canadian Thoracic Society Chronic Obstructive Pulmonary Disease Pharmacotherapy Guidelines: A Hospital-Based Study.
      aug:
        au: Saint-Pierre, Mathieu D.
        affil: 12365 University of Ottawa, Faculty of Medicine, Ottawa, ON, Canada
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        subj:
          Pulmonary Disease, Chronic Obstructive
          Bronchodilator Agents
          Practice Guidelines
          Emergency Service
          Guideline Adherence Evaluation
          Human
          Male
          Female
          Adult
          Retrospective Design
          Record Review
          Funding Source
          Patient Selection
          Disease Management
          Patient Care Plans
          Health Services Needs and Demand
          Canada
          Adult: 19-44 years
          Male
          Female
      ab: Background: A previous study at Montfort Hospital (Ottawa, Ontario, Canada) found that only one-fifth of patients treated in 2022 for a severe acute exacerbation of chronic obstructive pulmonary disease (AECOPD) were prescribed the appropriate inhaled therapy at discharge. The revised 2023 Canadian Thoracic Society (CTS) COPD pharmacotherapy guidelines now recommend inhaled triple therapy as initial maintenance treatment in patients at high risk of AECOPD. Objectives: The primary objective of this study was to determine if adherence to the CTS guidelines significantly improved following the publication of the 2023 statement. A secondary objective was to review the proportion of patients receiving appropriate optimization based on whether they were treated exclusively in the emergency department (ED) or required hospitalization. Design: Retrospective study Methods: Subjects treated for AECOPD in the first 12 months after the publication of the 2023 guidelines were reviewed. Patient characteristics and inhaled therapy were charted. Adherence to the guidelines was compared to the prior cohort from 2022. Results: A total of 169 patients were treated for AECOPD. After excluding individuals who died in the hospital and those who were maintained on inhaled triple therapy, 74 were candidates for review of their inhaled therapy. 27% received recommended medication optimization at discharge compared to 20% in 2022 (P = 0.25). Adherence to the guidelines significantly improved for hospitalized patients (51% vs 27%, P = 0.02). Only 5% of subjects treated exclusively in the ED received appropriate inhaler optimization. The most common deviations from the guidelines were the continued use of prior therapy (35%) and the lack of any long-acting medication (22%). Conclusions: Adherence to the CTS COPD pharmacotherapy guidelines remained very low in ED-treated patients. The findings highlight the need for structured COPD care plans.
      pubtype: Academic Journal
      doctype:
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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