Related Experiment Video
Updated: Apr 26, 2026
Generation of a Chronic Obstructive Pulmonary Disease Model in Mice by Repeated Ozone Exposure
Published on: August 25, 2017
Hospitalized patients with COPD: analysis of prior treatment
Irai Luis Giacomelli1, Leila John Marques Steidle1, Frederico Fernandes Moreira1
1Federal University of Santa Catarina, Florianópolis, Brazil.
Insights
Maintenance treatment for Chronic Obstructive Pulmonary Disease (COPD) in Brazil is often inappropriate, with undertreatment being a significant issue, especially in severe cases. Optimizing COPD care remains a challenge.
Area of Science:
- Pulmonology
- Public Health
Background:
- Chronic Obstructive Pulmonary Disease (COPD) is a widespread respiratory condition that is frequently undertreated.
- Limited data exist on the prior management of COPD patients in Brazil.
Purpose of the Study:
- To evaluate the appropriateness of maintenance treatment for COPD patients before hospitalization in Brazil.
- To identify factors linked to inappropriate COPD management.
Main Methods:
- An observational, cross-sectional study was conducted with 50 COPD inpatients in Florianópolis, Brazil.
- Patient data on non-pharmacological and pharmacological COPD management were collected via questionnaire.
- Treatment appropriateness was assessed against Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2011 and Brazilian Primary Care Guidebook (CAB) guidelines.
Main Results:
- Most patients had severe or very severe COPD.
- Non-pharmacological management was suboptimal: 33% were smokers, 32% advised flu vaccine, 28% received pneumococcal vaccine, and only 6.5% received pulmonary rehabilitation.
- Pharmacological treatment was inappropriate in 50% (GOLD) and 74% (CAB) of patients, with 38% undertreated per GOLD guidelines. Low education, low income, lack of oxygen therapy, and no flu vaccine were associated with inappropriate treatment.
Conclusions:
- Non-pharmacological COPD management strategies were poorly implemented.
- Undertreatment significantly contributed to the high rate of inappropriate maintenance therapy based on GOLD recommendations.
- Improving COPD treatment, even in severe instances, presents a considerable challenge in Brazil.
Objective:
Although COPD is a prevalent disease, it is undertreated, and there are no available data regarding previous treatment of COPD in Brazil. This study aimed to determine the appropriateness of maintenance treatment in COPD patients prior to their hospitalization and to identify variables associated with inappropriate treatment.
Methods:
This was an observational, cross-sectional, analytical study involving 50 inpatients with COPD at two hospitals in the city of Florianópolis, Brazil. The patients completed a questionnaire on parameters related to the maintenance treatment of COPD. Non-pharmacological management and pharmacological treatment were assessed based on the recommendations made by the Global Initiative for Chronic Obstructive Lung Disease (GOLD) in 2011 and by the Brazilian National Ministry of Health in the chronic respiratory diseases section of its Caderno de Atenção Básica (CAB, Primary Care Guidebook).
Results:
In most of the patients, the COPD was classified as being severe or very severe. Regarding non-pharmacological management, 33% of the patients were smokers, only 32% had been advised to receive the flu vaccine, 28% had received pneumococcal vaccine, and only 6.5% of the patients in the B, C, and D categories received pulmonary rehabilitation. Regarding GOLD and CAB recommendations, pharmacological treatment was inappropriate in 50% and 74% of the patients, respectively. Based on GOLD recommendations, 38% were undertreated. A low level of education, low income, not receiving oxygen therapy, and not receiving the flu vaccine were associated with inappropriate treatment.
Conclusions:
The application of various non-pharmacological management recommendations was unsatisfactory. Regarding the GOLD recommendations, the high rate of inappropriate maintenance treatment was mainly due to undertreatment. In Brazil, even in severe COPD cases, optimizing treatment to achieve greater benefits continues to be a challenge.
More Related Videos
Related Concept Videos
01:24Chronic Obstructive Pulmonary Disease
Smoking is a primary risk factor for COPD, with over 80% of patients having a history of it. Patients typically experience progressive dyspnea or labored breathing, frequent coughing, and recurrent pulmonary infections. Many eventually succumb to respiratory failure, characterized by...
01:29Chronic Obstructive Pulmonary Disease-V: Management
Smoking Cessation
01:27Chronic Obstructive Pulmonary Disease-IV: Assessement and Diagnostic Studies
Medical History
01:20Chronic Obstructive Pulmonary Disease-I: Introduction
01:23Chronic Obstructive Pulmonary Disease I: Introduction
01:24Chronic Obstructive Pulmonary Disease III: Chronic Bronchitis Features