Evaluation of adherence to chronic obstructive pulmonary disease prescribing guidelines- A single centre study

Introduction: Chronic obstructive pulmonary disease (COPD) is a worldwide health problem.Evidence suggests that the management of COPD patients is substandard when compared to treatment guidelines.Methods: A retrospective cross-sectional audit of patients admitted over 12-months for management of exacerbations of COPD (ICD-M120) was conducted in an Australian hospital.Data collected included patients' demographics, co-morbidities, admitting team, COPD-related medications on admissions and discharge, and spirometry data.The primary aim of this study was to evaluate the proportion of patients who were prescribed evidence-based COPD therapy on discharge compared to admission.The secondary aims were to evaluate adherence of the respiratory team to prescribing guidelines compared to general medical teams as well as assessing factors for prescribing compliance.Results: A total of 274 patients were eligible to be included.On discharge, the percentage of appropriate therapy increased from 44% to 53% compared to that on admission, p<0.01.A slightly higher percentage of patients (56%) were discharged on recommended therapy when managed by respiratory teams compared to non-specialised teams (50%), p=0.389.Patients who had asthma or previous exacerbations of COPD were more likely to receive optimum treatment; OR=9.444 95%CI (1.982-44.998)and OR=2.940 (1.706-5.068),p<0.01 respectively.Conclusion: This study identified gaps in the management of COPD patients in this tertiary setting.A better compliance to prescribing guidelines was observed among respiratory specialists.Patients with a history of asthma and/or multiple exacerbation of COPD were more likely to be optimally treated in this study.Improving awareness of COPD guidelines is vital for patients' management.