 |
 |
Respirology
10:341-348,
2005 |
|
|
|
Patterns of Care for Chronic Obstructive
Pulmonary Disease by Japanese Physicians |
|
|
|
Fukuhara S, Nishimura M,
Nordyke RJ, Zaher CA, Peabody JW. |
|
|
|
|
Objectives: Chronic
Obstructive Pulmonary Disease (COPD) treatment guidelines are
available worldwide, yet it is not known how widely they are
followed. This study evaluates the clinical care of COPD in
Japan compared to guideline recommendations. |
|
|
|
Methods: A
convenience sample of generalist and specialist physicians was
selected from private outpatient practices and public
hospitals in Japan. Physicians were provided two clinical
vignettes (COPD and asthma) and asked to make a diagnosis.
They were next asked to define diagnostic tests and treatment
recommendations specifically for a COPD patient. Responses
were compared to recommendations from current COPD
Guidelines. |
|
|
|
Results: For the COPD
unknown vignette, 6.2% of physicians diagnosed COPD while 54%
diagnosed chronic bronchitis or emphysema. For COPD diagnosis,
81.9% of physicians recommended a chest X-ray, 49.1%
spirometry, and 17.7% CT scan. The most frequently recommended
medication for a newly diagnosed COPD patient was theophylline
(37.2%) followed by expectorants (32.1%) and inhaled
anticholinergics (25.9%). Inhaled beta-agonists were
recommended by less than 20% of all physicians. |
|
|
|
Conclusions: Care for
COPD by selected Japanese physicians diverges from published
practice guidelines. COPD is an infrequently used diagnostic
label, diagnostic evaluation is characterized by a high use of
CT scans, particularly by specialists, and bronchodilator use
was low. | |
|
| |