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Characterization of...
Characterization of secondary care for COPD in Sweden
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- Sundh, Josefin, 1972- (författare)
- Örebro universitet,Institutionen för medicinska vetenskaper,Region Örebro län,Department of Respiratory Medicine, Örebro University Hospital, Örebro, Sweden,Univ Örebro, Sch Med Sci, Dept Resp Med, Örebro, Sweden.
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- Janson, Christer (författare)
- Uppsala universitet,Lungmedicin och allergologi
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- Johansson, Gunnar (författare)
- Uppsala universitet,Allmänmedicin och preventivmedicin
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- Lindén, Anders (författare)
- Karolinska Institutet
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- Löfdahl, Claes-Goran (författare)
- Department of Respiratory Medicine and Allergology, Lund University, Lund, Sweden,Lund Univ, Dept Resp Med & Allergol, Lund, Sweden.
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- Sandström, Thomas (författare)
- Umeå universitet,Medicin,Umeå Univ, Div Med, Dept Publ Hlth & Clin Med, Umeå, Sweden.
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- Larsson, Kjell (författare)
- Karolinska Institutet
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(creator_code:org_t)
- 2017-01-24
- 2017
- Engelska.
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Ingår i: European Clinical Respiratory Journal. - : Taylor & Francis. - 2001-8525. ; 4, s. 1-8
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Abstract
Ämnesord
Stäng
- Introduction: Only a selected proportion of chronic obstructive pulmonary disease (COPD) patients are managed in secondary care. The aim of this study was to characterize disease severity, treatment and structure of secondary care for COPD in Sweden.Methods: Information was collected from 29 of 33 existing secondary care units of respiratory medicine in Sweden, using both individual data from 373 consecutively enrolled COPD patients with Global initiative on Obstructive Lung Disease (GOLD) stage III-IV and a structural questionnaire about available resources at the units. Patient data included exacerbations, health status assessed by COPD Assessment Test (CAT), lung function, comorbid conditions, pharmacological treatment and vaccinations. Structural data included available smoking cessation support, multi-disciplinary rehabilitation, physical training, patient education and routine follow-up after exacerbations at the respective unit. All patients were reclassified according to the GOLD 2014 group AD classification. Multiple linear regression investigated associations of available resources with number of exacerbations and CAT score.Results: According to GOLD 2014, 87% of the population were GOLD D and 13% were GOLD C. Triple inhaled therapy were prescribed in 88% of the patients. Over 75% of the units had resources for smoking cessation, multidisciplinary rehabilitation, physical training and patient education. Routine follow-up after exacerbations was available in 35% of the units. Being managed at units with access to structured patient education was associated with statistically significantly fewer exacerbations (adjusted regression coefficient (95% confidence interval) -0.79 (-1.39 to -0.19), p = 0.010).Conclusion: Most stage III-IV COPD patients managed at secondary care respiratory units in Sweden have maximized inhaled therapy and high risk disease even when reclassified according to GOLD 2014. Most units have access to smoking cessation, rehabilitation and patient education. Patients managed at units with structured patient education have a lower exacerbation risk.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Lungmedicin och allergi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Respiratory Medicine and Allergy (hsv//eng)
Nyckelord
- GOLD classification
- pharmacological therapy
- structural resources
- patient education
Publikations- och innehållstyp
- ref (ämneskategori)
- art (ämneskategori)
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