1,720,992 research outputs found
Primary care of the patient with chronic obstructive pulmonary disease in Italy
No full textUsing a general practice research database with general. practitioner (GP) clinical. records, it has been observed that among the 617,280 subjects registered with 400 Italian GPs, 15,229 (2.47%) patients were suffering from chronic obstructive pulmonary disease (COPD). Of these, 67.7% had a chest radiograph at least once in a period of 10 years (1997-2006), while in the same period only 31.9% had a spirometry, 29.9% had a visit to a specialist, and 0.94% had a visit to an allergologist. From 1997 to 2006, 7.5% of patients with COPD, especially the oldest ones, were hospitalized at least once for the disease, although 44.0% of all. patients with COPD were hospitalized for other pathologies. With regard to treatment, in 2006, 10,936 (71.1%) of COPD patients received at least one drug for their disease (drugs classified within the R03 therapeutic pharmacological subgroup of the Anatomical Therapeutic Chemical Classification). In particular, salmeterol/fluticasone was prescribed 6441 times, tiotropium 4962, theophylline 3142, beclomethasone 2853, salbutamol 2256, formoterol 2191, salbutamol/beclomethasone 2129, oxitropium 1802 and formoterol/budesonide 1741 times. Based on these findings, the level of COPD management in Italy seems to fall short of recommended international COPD guidelines. In particular, it appears that GPs usually prescribe treatment without the use of spirometry, and/or without taking into account the severity of airway obstruction. It must also be noted that, in general, patients with COPD are undertreated. (c) 2008 Elsevier Ltd. All rights reserved
Prevalence of comorbidities in patients with chronic obstructive pulmonary disease.
No full textBACKGROUND: Chronic obstructive pulmonary disease (COPD) is associated with many comorbidities, but the percentage of COPD patients who develop comorbidities has not been clearly defined.
OBJECTIVES: We aimed to examine the relationship between COPD and comorbidities using information obtained from the Health Search Database (HSD) owned by the Italian College of General Practitioners (SIMG), which stores information on about 1.5% of the total Italian population served by general practitioners.
METHODS: We conducted a population-based retrospective study using information obtained from the HSD. The software system used codes all the diagnostic records using the 9th Revision of the International Classification of Diseases.
RESULTS: Compared to the non-COPD people, COPD patients were at increased risk for cardiovascular events [ischemic heart disease (6.9% in the general population vs. 13.6% in COPD patients), cardiac arrhythmia (6.6% in the general population vs. 15.9% in COPD patients), heart failure (2.0% in the general population vs. 7.9% in COPD patients), and other forms of heart disease (10.7% in the general population vs. 23.1% in COPD patients); with a higher impact of COPD in the elderly]; non-psychotic mental disorders, including depressive disorders (29.1% in the general population vs. 41.6% in COPD patients; with a higher impact of COPD on women aged <75 years); diabetes mellitus (10.5% in the general population vs. 18.7% in COPD patients); osteoporosis (10.8% in the general population vs. 14.8% in COPD patients), with a higher impact of COPD on women aged <75 years, and malignant pulmonary neoplasms (0.4% in the general population vs. 1.9% in COPD patients).
CONCLUSIONS: Our results indicate that COPD is a risk factor for these comorbid conditions
Bereavement and Critical Incidents Involving Healthcare Professionals in Italy During COVID-19: The Importance of the Spiritual Dimension
Full text linkThis exploratory research investigated the work of healthcare professionals during the COVID-19 pandemic, highlighting the major critical aspects, including healthcare providers' needs as well as personal, professional, and social changes brought about by the pandemic upon both living and dying. In general, for many healthcare providers, the changes imposed by COVID-19 together with their inadequate training led to an excessive emotional load that caused high levels of stress and, consequently, the risk of burnout. In the present study, we wanted to investigate the impact of the COVID-19 pandemic on healthcare professionals and to explore if and how spirituality influenced their experience. We adopted a qualitative methodological design based on interpretative phenomenological analysis. The respondents were 15 healthcare professionals (12 general practitioners, 1 physician, and 2 nurses). This research was carried out in Italy during the first lockdown, that is, between March and September 2020. Following the analysis of participants' experiences, four main themes were created: (1) critical issues in healthcare, critical incidents, and changes in the attitudes and habits of general practitioners during the pandemic; (2) emotional experiences and primary needs during the emergency; (3) dying during the pandemic and new psychological symptoms in noninfected patients; and (4) resilience and the role of spirituality. Since healthcare professionals, and general practitioners more specifically, were extensively exposed to the dying process and to changes in the end-of-life scenario, the support offered by palliative care is desirable, in terms of both the special skills that palliative physicians can provide and the presence of psychologists as well as through death education
Implementazione delle linee guida sull’asma bronchiale in Italia: l’opinione del medico di medicina generale
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Quality of life in asthma and COPD: is it measurable in primary care?
No full textBackground. An observational cross-sectional study under the acronym CORDIS (Chronic Obstructive Respiratory
Disease - Italian Study), performed in primary care centers to evaluate the knowledge and the degree
of control of physician-diagnosed asthma and chronic obstructive pulmonary disease (COPD) by Italian General
Practitioners (GPs). The study consisted of two phases, CORDIS-A and CORDIS-B. The CORDIS-B study
included measurement of the quality of life (QoL) of physician-diagnosed asthma and COPD patients.
Aim. Aim of the study was to evaluate the applicability of QoL assessment by means of the SF-12 Questionnaire
in primary care in subjects with asthma or COPD. Secondary, to evaluate the impact of the two
respiratory diseases on patients’ QoL and to measure the correlation between patients’ and GPs’ opinion on
patients’ health status.
Methods. Patients enrolled in the study were males and females aged more than 18 years, with a physician
(GP or specialist) diagnosis of asthma and/or COPD and treated from at least 12 months with a short-term
inhaled β2-agonist, given alone or as component of a multiple therapy. Patients gave written informed consent
to participate to the study and for personal data use. Each patient enrolled in the study privately filled in the
QoL SF-12 questionnaire; both the patient and the GP gave independently the judgement of patient’s health
(Excellent, Very good, Good, Acceptable, Poor) and the two opinions were compared.
Results. Complete QoL data were available for 11,642 subjects with a mean age of 57 ± 17 years and a
prevalence of males of 55.3%. The percentage of patients with asthma, COPD, and asthma plus COPD was
47.2%, 29.2% and 23.6%, respectively. At least one concomitant disease was present in 67% of patients.
In terms of evaluation of patient’s health status, a perfect concordance between the two types of evaluators
was found in 54.6%; the percentage increased up to 95% when considering just one category of difference
between the GP’s and the patient’s evaluation. As for the general Italian population, no substantial gender
difference was found in our study for the SF-12 “Physical Component Summary” (PCS) and “Mental Component
Summary” (MCS) mean scores. However, the CORDIS-B subjects showed more impaired health status
in comparison to general population. Asthmatic patients showed better PCS and MCS scores in comparison
to patients with COPD or asthma plus COPD (p < 0.0001).
Conclusions. This study shows that a) the SF-12 Questionnaire is a simple and useful tool to measure the
QoL of patients with asthma and COPD in primary care; b) there was a very good agreement in the subjective
evaluation of the patient’s health status between GP and patient; c) mental/psychological component is
underestimated both by GP and patient
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