【COPD英文PPT课件】COPD MANAGEMENT FALLS SHORT AT RCRMC
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INCLUSIONS; Outpatients of both Family Care Clinic and Internal Medicine Primary Care Clinic. Patients with the diagnosis of COPD.
EXCLUSIONS: Patients treated only in clinics other than primary care clinics. Patients treated only as inpatients in the hospital. Patients without the diagnosis of COPD.
METHODS: retrospective analysis of 150 patients with the diagnosis of COPD by reviewing the charts of these patients. Charts were pulled randomly by Medical Records personnel according to the requirement of patient had to have the diagnosis of COPD at some point and patient had to have been a clinic outpatient.
MEDICATIONS PRESECRIBED FOR THEIR COPD
-Albuterol: 104 (69%) -Inhaled Corticosteroids: 61 (41%) -Spiriva (tiotropion): 54 (36%) -Atrovent (ipratropium): 41 (27%) -Combivent: 10 (7%) -Servent diskus: 2 (1%) -Theophylline: 1(0.01%) -Long-term oxygen: 17 (11%)
RESULTS
PATIENT DEMOGRAPHICS
The final number of charts reviewed for this project was 150.
GENDER; Female: 77 (51%)
Male 73 (49%)
AGE; 20’s: 0 (0%)
30’s: 4(2%) 40’s: 18(2%) 50’s: 69 (46%) 60’s: 43 (29%) 70’s: 12(8%) 80’s: 4(2%)
STAGE I – Mild – FEV1/FVC ratio less than 70%. FEV1 at least 80% of predicted value. May have symptoms
STAGE II – Moderate – FEV1/FVC ratio less than 70%. FEV1 50% to less than 80% of predicted value. May have chronic symptoms.
OR
chronic symptoms.
- FEV1 less than 50 % of predicted value plus severe
HYPOTHESIS: The majority of our hospital’s primary care clinic patients diagnosed with COPD received the diagnosis on clinical grounds alone, without documented confirmation of the diagnosis by spirometry.
COPD MANAGEMENT FALLS SHORT AT RCRMC
Jean Solomon, M.D.
STAGING OF COPD
GOLD system uses a combination of FEV1 and patient symptoms
STAGE 0 – At risk – Risk factors and chronic symptoms, but normal spirometry
RACE; Cauc: 55 (37%)
AA: 19 (13%) Asian/Pacific: 5 (3%) Other: 3 (2%) Unknown: 52 (35%) Hispanic: 16 (11%)
SMOKERS (PAST OR PRESENT)
Yes: 132 (88%) Never: 18 (12%)
STAGE III – Severe – FEV1/FVC ratio less than 70%. FEV1 30% to less than 50% of predicted value. May have chronic symptoms.
STAGE IV – Very severe – FEV1/Leabharlann BaiduVC ratio less than 70%. FEV1 less than 30% of predicted value.
*SPIROMETRY NOT PERFORMED; 99 (66%)
*OF THE PATIENTS WHO HAD SPIROMETRY, SPIROMETRY CONFIRMED THE DIAGNOSIS OF COPD; 22 (43%)
CLINIC PATIENT WENT TO
Family Care Clinic: 82 (55%) Internal Medicine Clinic: 68 (45%)
RESULTS
*SPIROMETRY PERFORMED IN THE PAST 10 YEARS IN A PATIENT WHO AT SOME POINT WAS GIVEN THE DIAGNOSIS OF COPD; 51 (34%)
EXCLUSIONS: Patients treated only in clinics other than primary care clinics. Patients treated only as inpatients in the hospital. Patients without the diagnosis of COPD.
METHODS: retrospective analysis of 150 patients with the diagnosis of COPD by reviewing the charts of these patients. Charts were pulled randomly by Medical Records personnel according to the requirement of patient had to have the diagnosis of COPD at some point and patient had to have been a clinic outpatient.
MEDICATIONS PRESECRIBED FOR THEIR COPD
-Albuterol: 104 (69%) -Inhaled Corticosteroids: 61 (41%) -Spiriva (tiotropion): 54 (36%) -Atrovent (ipratropium): 41 (27%) -Combivent: 10 (7%) -Servent diskus: 2 (1%) -Theophylline: 1(0.01%) -Long-term oxygen: 17 (11%)
RESULTS
PATIENT DEMOGRAPHICS
The final number of charts reviewed for this project was 150.
GENDER; Female: 77 (51%)
Male 73 (49%)
AGE; 20’s: 0 (0%)
30’s: 4(2%) 40’s: 18(2%) 50’s: 69 (46%) 60’s: 43 (29%) 70’s: 12(8%) 80’s: 4(2%)
STAGE I – Mild – FEV1/FVC ratio less than 70%. FEV1 at least 80% of predicted value. May have symptoms
STAGE II – Moderate – FEV1/FVC ratio less than 70%. FEV1 50% to less than 80% of predicted value. May have chronic symptoms.
OR
chronic symptoms.
- FEV1 less than 50 % of predicted value plus severe
HYPOTHESIS: The majority of our hospital’s primary care clinic patients diagnosed with COPD received the diagnosis on clinical grounds alone, without documented confirmation of the diagnosis by spirometry.
COPD MANAGEMENT FALLS SHORT AT RCRMC
Jean Solomon, M.D.
STAGING OF COPD
GOLD system uses a combination of FEV1 and patient symptoms
STAGE 0 – At risk – Risk factors and chronic symptoms, but normal spirometry
RACE; Cauc: 55 (37%)
AA: 19 (13%) Asian/Pacific: 5 (3%) Other: 3 (2%) Unknown: 52 (35%) Hispanic: 16 (11%)
SMOKERS (PAST OR PRESENT)
Yes: 132 (88%) Never: 18 (12%)
STAGE III – Severe – FEV1/FVC ratio less than 70%. FEV1 30% to less than 50% of predicted value. May have chronic symptoms.
STAGE IV – Very severe – FEV1/Leabharlann BaiduVC ratio less than 70%. FEV1 less than 30% of predicted value.
*SPIROMETRY NOT PERFORMED; 99 (66%)
*OF THE PATIENTS WHO HAD SPIROMETRY, SPIROMETRY CONFIRMED THE DIAGNOSIS OF COPD; 22 (43%)
CLINIC PATIENT WENT TO
Family Care Clinic: 82 (55%) Internal Medicine Clinic: 68 (45%)
RESULTS
*SPIROMETRY PERFORMED IN THE PAST 10 YEARS IN A PATIENT WHO AT SOME POINT WAS GIVEN THE DIAGNOSIS OF COPD; 51 (34%)