Knowledge of guidelines for the management of COPD: a survey of primary care physicians - Rutschmann, O. T.; Janssens, J. P.; Vermeulen, B.; Sarasin, F. P. (Respir Med, 2004)
OBJECTIVES: To evaluate primary care physicians' knowledge of guidelines for the management of COPD. METHOD: Survey to 455 primary care physicians in private practice in the state of Geneva, Switzerland, and to 243 physicians practicing in Geneva University Hospital. RESULTS: Although 75% of respondents identified that the prevalence of COPD was increasing and 33% recognized it as a major public health issue, only 55% of physicians used spirometric criteria to define COPD, and one-third knew the correct GOLD criteria. Fifty-two percent felt uncomfortable with smoking cessation counselling. Sixty-two percent administered influenza vaccination annually and 29% had immunized their patients against Pneumococcus. Beta2-agonists were the first-line treatment for 89% of physicians, but 10% overestimated their clinical benefit. Twenty-five percent of respondents used systematically inhaled corticosteroids, but 46% ignored their indications. Oral corticosteroids were used by 42% of physicians outside of acute exacerbations. Seventy-nine percent thought that oral steroids had a beneficial effect on stable COPD. Finally, pulmonary rehabilitation was underused by 72% of physicians. CONCLUSIONS: This study shows major gaps in the knowledge of all core elements of guidelines for the management of COPD and identifies targets for future educational programs.
Keywords: journalArticle; *Clinical Competence; *Practice Guidelines as Topic; *Primary Health Care; Adolescent; Adult; Child; Child, Preschool; Cross-Sectional Studies; Female; Humans; Infant; Infant, Newborn; Male; Middle Aged; Prospective Studies; Pulmonary Disease, Chronic Obstructive/*therapy; Risk Factors; Surveys and Questionnaires