Citation Information :
Khanna A, Bajad P, Pahuja S, Agarwal S, Goel I. Analysis of Physician Prescription Patterns in Patients with Advanced Chronic Obstructive Pulmonary Disease. Indian J Respir Care 2023; 12 (4):325-329.
Background: Chronic obstructive pulmonary disease (COPD) is a worldwide health problem that is increasing in prevalence. There are practice differences between general physicians and respiratory physicians, and it is expected that not everyone would follow the prescribed guidelines fully.
Objectives: The objective of the study was to examine the practice standards of general physicians with postgraduate medicine degrees and evaluate their influence on disease control in COPD patients.
Materials and methods: A retrospective, observational study among 60 consecutive patients with advanced COPD patients who were seen at a tertiary care center in North India at the Department of Respiratory and Critical Care Medicine over a period of 6 months from February to July 2022.
Results: In this study, data from 60 patients were retrieved who were undergoing treatment from a randomly selected doctor of medicine/diplomate of national board (MD/DNB) physicians. Very few physicians prescribed spirometry to diagnose COPD; however, most patients had undergone a high-resolution computed tomography (HRCT) chest. Around 93.3% of patients continued using both nebulization and handheld inhalers. Around 96.6% of the study patients were prescribed short-acting bronchodilators (SABAs). None of the patients were given any prescription for smoking cessation and pulmonary rehabilitation. Influenza and pneumococcal vaccination were also prescribed to a small number of patients.
Conclusion: Overall, it appears that general physicians continue to treat COPD patients with traditional forms of treatment, and very few treat patients as per the updated guidelines.
Global Strategy for the. Diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD Executive Summary. https://goldcopd.org/2022-gold-reports/
Gupta D, Agarwal R, Aggarwal AN, et al. COPD Guidelines Working Group Guidelines for diagnosis and management of chronic obstructive pulmonary disease. Lung India 2013;30(3):228–267. DOI: 10.4103/0970-2113.116248
Mahadeo PS, Sudhir LP, Anand SK, et al. Study of drug prescription pattern among COPD patients admitted to medicine in-patient department of tertiary care hospital. Int J Basic Clin Pharmacol 2017;6(9):2228–2232. DOI: 10.18203/2319-2003.ijbcp20173750
Kumar S, Madhuri G, Wilson A, et al. Study of prescribing pattern of drugs in chronic obstructive pulmonary disease in tertiary care teaching hospital. Indian J Pharmacy Practice 2019;12(3):161–166. DOI: 10.5530/ijopp.12.3.36
Sinha B, Vibha, Singla D, Chowdhury R. An epidemiological profile of chronic obstructive pulmonary disease: a community-based study in Delhi. J Postgrad Med 2017;63(1):29–35. DOI: 10.4103/0022-3859.194200
Maqusood M, Khan FA, Kumar M. A study of prescription pattern in the management of copd in a tertiary care hospital. Ann Int Med Dent Res 2016;2:159–163. DOI: 10.21276/aimdr.2016.2.3.39
Vanjare N, Chhowala S, Madas S, et al. Use of spirometry among chest physicians and primary care physicians in India. NPJ Prim Care Respir Med 2016; 26:16036. DOI: 10.1038/npjpcrm.2016.36
Shah U, Jayalakshmi TK, Mirchandani L, et al. COPD phenotypes according to high resolution CT scan findings. D Y Patil J Health Sci 2014;1(2):1–6.
Purohit S, Dutt N, Kumar S. High resolution computed tomography in chronic obstructive pulmonary disease patients: do not forget radiation hazard. Lung India 2016;33(5):582–583. DOI: 10.4103/0970-2113.189006
Sharafkhaneh A, Wolf RA, Goodnight S, et al. Perceptions and attitudes toward the use of nebulized therapy for COPD: patient and caregiver perspectives. COPD 2013;10(4):482–492. DOI: 10.3109/15412555.2013.773302
Guleria RJ, Thakkar KM. Nebulizer practices among paramedics in India. Lung India 2019;36(1):80–81. DOI: 10.4103/lungindia.lungindia_147_18
Unni A, Jayaprakash KA, Yadukrishnan MC, et al. Drug utilization pattern in chronic obstructive pulmonary disease inpatients at a tertiary care hospital. Int J Pharm Pharm Sci 2015;7(11):389–391.
Veettil SK, Rajiah K, Kumar S. Study of drug utilization pattern for acute exacerbation of chronic obstructive pulmonary disease in patients attending a government hospital in kerala, India. J Family Med Prim Care 2014;3(3):250–254. DOI: 10.4103/2249-4863.141622
Zheng JP, Wen FQ, Bai CX. High-dose N-acetylcysteine in the prevention of COPD exacerbations: rationale and design of the PANTHEON Study. COPD 2013;10(2):164–171. DOI: 10.3109/15412555.2012.732628
Salve VT, Atram JS. N-acetylcysteine combined with home based physical activity: effect on health related quality of life in stable COPD patients- a Randomised Controlled Trial. J Clin Diagn Res 2016;10(12):16–19. DOI: 10.7860/JCDR/2016/23668.8980
Kale SB, Patil AB, Kale A. Effects of administration of oral n-acetylcysteine on oxidative stress in chronic obstructive pulmonary disease patients in rural population. Int j basic Clin Pharmacol 2016;5(3):775–781. DOI: 10.18203/2319-2003.ijbcp20161518
Mulpuru S, Li L, Ye L, et al. Serious Outcomes Surveillance (SOS) Network of the Canadian Immunization Research Network (CIRN). Effectiveness of influenza vaccination on hospitalizations and risk factors for severe outcomes in hospitalized patients with COPD. Chest 2019;155(1):69–78. DOI: 10.1016/j.chest.2018.10.044