现实世界中慢性阻塞性肺病的临床管理:研究能否揭示管理中的错误和改善患者护理的途径?

IF 2.3 Q2 MEDICINE, GENERAL & INTERNAL Pragmatic and Observational Research Pub Date : 2023-01-01 DOI:10.2147/POR.S396830
David M G Halpin
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引用次数: 0

摘要

真实世界的数据包括来自典型临床研究环境之外的多个来源的卫生保健信息。这篇综述的重点是现实世界的证据告诉我们慢性阻塞性肺疾病(COPD)的诊断问题,初始和随访药物和非药物管理问题,恶化管理问题和姑息治疗问题。来自现实世界的研究数据显示,COPD的管理存在错误,包括延误诊断、缺乏肺活量测定法对诊断的确认、缺乏整体评估、缺乏对戒烟的关注、对管理指南的不同遵守、适当干预措施的延迟实施、对不良后果高风险患者的认识不足、病情加重住院率高以及姑息治疗实施不力。了解这些问题的存在,并考虑其发生的方式和原因,对于制定改善慢性阻塞性肺病患者诊断和管理的解决方案至关重要。
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Clinical Management of COPD in the Real World: Can Studies Reveal Errors in Management and Pathways to Improve Patient Care?

Real world data comprise information on health care that is derived from multiple sources outside typical clinical research settings. This review focuses on what real world evidence tells us about problems with the diagnosis of chronic obstructive pulmonary disease (COPD), problems with the initial and follow-up pharmacological and non-pharmacological management, problems with the management of exacerbations and problems with palliative care. Data from real world studies show errors in the management of COPD with delays to diagnosis, lack of confirmation of the diagnosis with spirometry, lack of holistic assessment, lack of attention to smoking cessation, variable adherence to management guidelines, delayed implementation of appropriate interventions, under-recognition of patients at higher risk of adverse outcomes, high hospitalisation rates for exacerbations and poor implementation of palliative care. Understanding that these problems exist and considering how and why they occur is fundamental to developing solutions to improve the diagnosis and management of patients with COPD.

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来源期刊
Pragmatic and Observational Research
Pragmatic and Observational Research MEDICINE, GENERAL & INTERNAL-
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期刊介绍: Pragmatic and Observational Research is an international, peer-reviewed, open-access journal that publishes data from studies designed to closely reflect medical interventions in real-world clinical practice, providing insights beyond classical randomized controlled trials (RCTs). While RCTs maximize internal validity for cause-and-effect relationships, they often represent only specific patient groups. This journal aims to complement such studies by providing data that better mirrors real-world patients and the usage of medicines, thus informing guidelines and enhancing the applicability of research findings across diverse patient populations encountered in everyday clinical practice.
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