Gender inequalities in COPD decision-making in primary care

Area of Science:

• Pulmonary Medicine
• Health Services Research
• Gender Studies

Background:

• Chronic Obstructive Pulmonary Disease (COPD) disproportionately affects females, and existing research indicates gender-based inequalities in its care.
• Understanding these disparities is crucial for improving healthcare equity in COPD management.

Purpose of the Study:

• To investigate how family physician (FP) gender influences clinical decision-making for male versus female patients with COPD in primary care.
• To analyze potential gender-based differences in the assessment and management of COPD patients.

Main Methods:

• A cross-sectional, multicenter study involving 457 Andalusian FPs.
• A vignette-based questionnaire assessed four clinical reasoning variables: risk factor identification, spirometry ordering, diagnostic likelihood, and referral, presented for male and female COPD patients.
• Multilevel logistic regression analysis was employed to examine the data.

Main Results:

• Female patients were less frequently identified as having tobacco as a priority risk factor and less often had COPD as the most likely diagnosis compared to male patients, across both male and female FPs.
• Male FPs were more likely to order spirometry for male patients than for female patients.
• While no gender differences in referral were observed between male and female patients, male FPs were more likely to consider tobacco a priority RF for male patients, and female FPs were more likely to refer male patients.

Conclusions:

• Gender inequalities in primary care for COPD are suggested, with potentially lower diagnostic and therapeutic efforts for female patients.
• FP gender and patient gender interact, influencing care decisions, particularly in the management of male patients.
• Further research is needed to address these identified gender-based disparities in COPD care to ensure equitable treatment for all patients.