COPD: The application of the gold standard in the primary care setting.

摘要

Chronic Obstructive Pulmonary Disease (COPD) is the fourth leading cause of death in the U.S. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has provided guidelines for the diagnosis, staging, and treatment of COPD. Early diagnosis with spirometric confirmation offers the most favorable outcomes for those suffering from COPD. Spirometry can be completed easily in the primary care setting for those exhibiting symptoms or warning signs; however, there are an estimated 24 million people who remain undiagnosed. Once diagnosed, it is questionable as to whether or not these patients are being treated according to GOLD guidelines. This quantitative, descriptive study utilized a retrospective medical chart review supported by ACE Star Model of evidence- based practice to determine the prevalence of local primary care providers (PCPs) who are following the GOLD guidelines in the diagnosis and treatment of COPD and to provide objective data for further use in educating the PCPs. Data from 163 medical charts of eighteen primary care providers was collected and analyzed using simple and descriptive statistics. Patient charts reviewed were of those aged 40 and over with at least a 10-pack-year smoking history. The results of this study showed that spirometry was used for the purposes of diagnosis in 3.1% of the sample and that less than two-percent of the entire sample had been staged for disease progression. There were no appreciative differences between the types of providers in their practice patterns or between the practice sites.