Background Important role in the management of COPD have both pulmonary specialists (PSs) and general practitioners (GPs). Aims To study the medical care provided for COPD patients by PSs and GPs. Methods Both GPs and PSs filled in specially designed questionnaires. Theyprovidedinformation for randomly selected COPD patients on smoking status, disease severity, comorbidities, therapy, exacerbations, hospitalizations and management. Results Information about 556 patients was collected – 60.4% (336) were males. Smokers were 68.8% of all COPD patients. On combined inhalation therapy (inhaled corticosteroid and long acting beta-2- agonist – ICS/LABA) were 37.8%; 23.7% received long-acting bronchodilator therapy and 27.2% were on therapy with short-acting bronchodilators. Concomitant cardiovascular diseases had 77.3%. From all patients 25.8% had no exacerbation for the last 12 months, 38.0% had one and 36.2% had 2 or more, 33.5% had hospitalization due to COPD exacerbation (HE) and 21.9% due to concomitant diseases (HCD). A correlation between HE and therapy with ICS/LABA was found (p0.05). Patients with HE were also more likely to have a HCD (p0.05). Patients reported by PSs were mostly men (p0.05), smokers (p0.05), with more HE (p0.05), with higher usage of systemic corticosteroids during exacerbation (p0.05) and with lower mean FEV1 value (p0.05). Conclusion Pulmonologists follow-up more severe COPD patients who are mainly male smokers, have worse pulmonary function and frequent exacerbations and hospitalizations and use more oral corticosteroids compared to GPs. Patients with frequent COPD hospitalizations are also admitted to hospital more frequently for treatment of comorbidities.
Ivanov et al. (Mon,) studied this question.