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Patterns of care for COPD by Japanese physicians
Shunichi Fukuhara1, Masaharu Nishimura, Robert J Nordyke
1Kyoto University, Kyoto, Japan. fukuhara@pbh.med.kyoto-u.ac.jp
Respirology (Carlton, Vic.)
|June 16, 2005
Summary
Japanese physicians infrequently use the COPD diagnosis, with significant deviations in diagnostic tests and treatments compared to global guidelines. This highlights a gap in clinical practice for chronic obstructive pulmonary disease management.
Area of Science:
- Pulmonary Medicine
- Clinical Practice Guidelines
- Healthcare Quality
Background:
- Global guidelines exist for COPD treatment, but adherence is not well-documented.
- Assessing clinical practice against established guidelines is crucial for improving patient care.
Purpose of the Study:
- To evaluate the clinical care of patients with chronic obstructive pulmonary disease (COPD) in Japan.
- To compare physician practices against current COPD treatment guidelines.
Main Methods:
- Physicians in Japan (general and specialist) were surveyed using clinical vignettes.
- Physicians' diagnostic and treatment recommendations for COPD were compared to guideline recommendations.
Main Results:
- Only 6.2% of physicians diagnosed COPD; 54% used terms like chronic bronchitis or emphysema.
- Computed tomography scans were frequently recommended for diagnosis (17.7%), while spirometry was less common (49.1%).
- Theophylline was the most recommended medication (37.2%), with low use of inhaled beta-agonists (<20%).
Conclusions:
- Clinical care for COPD patients in Japan deviates significantly from published guidelines.
- The diagnostic label 'COPD' is underutilized, and diagnostic workups often include advanced imaging over spirometry.
- Bronchodilator use was notably low among surveyed physicians.