Management of chronic obstructive pulmonary disease by pharmacists in an internal medicine department

2009 ◽  
Vol 66 (10) ◽  
pp. 890-893 ◽  
Author(s):  
Rebecca P. Mann ◽  
Kathy Zaiken
Keyword(s):  
Internal Medicine ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Medicine Department ◽  
Internal Medicine Department

scholarly journals Management of chronic obstructive pulmonary disease exacerbations in Internal Medicine

2013 ◽  
pp. 199-214
Author(s):  
Gelorma Belmonte ◽  
Marilena Muratori ◽  
Paolo Leandri ◽  
Angelo Pasquale ◽  
Massimo Reta ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Chronic Obstructive Pulmonary Disease ◽  
Health Care ◽  
Pulmonary Disease ◽  
Cause Of Death ◽  
Easy Access ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Copd Exacerbations ◽  
Wide Range

Introduction: Chronic obstructive pulmonary disease (COPD) is the second leading cause of hospitalization in Internal Medicine departments in Italy and the fourth leading cause of death all over the word. By 2020, COPD will be the third leading cause of death and the fifth leading cause of disability. It is — along with chronic congestive heart failure — one of the most common causes of unscheduled hospital readmissions, and as such it represents a significant economic burden for the health-care system. Exacerbations of COPD are important events in the natural history of this prevalent condition. Discussion: This review provides a comprehensive state-of-the-art look at prevention and management of COPD exacerbations. Treatment of these episodes has to be tailored to the severity of the clinical presentation. We now have a wide range of therapeutic available options, based on the results of clinical trials. Management of the acute event should include the necessary measures (mainly the administration of inhaled short-acting bronchodilators, inhaled or oral corticosteroids, and antibiotics), with or without oxygen and ventilator support. Conclusions: To improve the management of COPD exacerbations, the focus of care must be shifted from the episodic acute complications to their systematic prevention. The management of COPD, which is often associated with multiple co-morbidities, is complex and requires a tailored, multifaceted and multidisciplinary approach. Integrated care for COPD also requires that patients be informed about their condition, that they participate actively in their care, and that they have easy access to the necessary health-care services.

Spanish clinical practice consensus in internal medicine on chronic obstructive pulmonary disease patients with comorbidities (miEPOC)

2020 ◽  
Vol 36 (6) ◽  
pp. 1033-1042
Author(s):  
Jesús Recio Iglesias ◽  
Francisco López García ◽  
Pere Almagro ◽  
José Manuel Varela Aguilar ◽  
Ramón Boixeda Viu
Keyword(s):  
Internal Medicine ◽  
Chronic Obstructive Pulmonary Disease ◽  
Clinical Practice ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

scholarly journals Analysis of the characteristics of patients admitted to Internal Medicine wards for exacerbation of chronic obstructive pulmonary disease, and discharge phase optimization. The SDO-ARCA Project of the Scientific Society FADOI

2020 ◽  
Vol 14 (3) ◽  
pp. 156-161
Author(s):  
Marco Candela ◽  
Claudio Norbiato ◽  
Mauro Campanini ◽  
Antonio Luca Brucato ◽  
Salvatore Di Simone ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Blood Gas Analysis ◽  
Gas Analysis ◽  
Chronic Obstructive ◽  
Post Discharge ◽  
Obstructive Pulmonary Disease ◽  
Exacerbation Of Copd ◽  
A Prospective Study

The purpose of this study was to have a nationwide snapshot of the characteristics of patients hospitalized in Internal Medicine Units (IMUs) for exacerbation of chronic obstructive pulmonary disease (COPD), and to assess applicability and contents of a specific Hospital Discharge Form for the patient with exacerbation of COPD discharged from IMUs. This was a prospective study in 44 IMUs in Italy, enrolling patients hospitalized with a diagnosis of COPD exacerbation. Information concerning clinical characteristics of patients, and treatment for COPD at discharge was collected. Specific documents for monitoring of clinical conditions and adherence to therapies as well as a form including individual indications for clinical controls, instrumental tests, etc. were provided upon discharge. Four hundred and seventy-two patients were enrolled (68% male). According to GOLD classification 2015, patients with classes A to D were 12%, 27%, 31%, and 30%, respectively. Triple therapy was prescribed in 14% of GOLD A and 51% of GOLD D patients. Around 10% of patients for each GOLD class received no specific therapy. The vast majority of patients (85%) received instructions on the correct use of inhalers, and in most cases (85%), the quality of counseling was considered optimal/adequate. Indication for performing chest X-ray, spirometry, or blood gas analysis following discharge was addressed to 29%, 59% and 52.1% of patients, respectively. The follow-up sheet for COPD used in our study was shown as applicable. This highlighted the need for greater awareness and more standardized procedures within IMUs in the post-discharge phase.

scholarly journals Impact of Quality Improvement on Care of Chronic Obstructive Pulmonary Disease Patients in an Internal Medicine Resident Clinic

Healthcare ◽  
2018 ◽  
Vol 6 (3) ◽  
pp. 88 ◽  
Author(s):  
Robert Burkes ◽  
Takudzwa Mkorombindo ◽  
Udit Chaddha ◽  
Alok Bhatt ◽  
Karim El-Kersh ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Chronic Obstructive Pulmonary Disease ◽  
Smoking Cessation ◽  
Quality Improvement ◽  
Pulmonary Disease ◽  
Pneumococcal Vaccination ◽  
Chronic Obstructive ◽  
Smoking Cessation Counseling ◽  
Obstructive Pulmonary Disease ◽  
Teaching Clinic

Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality. Guideline-discordant care of COPD is not uncommon. Further, there is a push to incorporate quality improvement (QI) training into internal medicine (IM) residency curricula. This study compared quality of care of COPD patients in an IM residents’ clinic and a pulmonary fellows’ clinic and, subsequently, the results of a quality improvement program in the residents’ clinic. Pre-intervention rates of quality measure adherence were compared between the IM teaching clinic (n = 451) and pulmonary fellows’ clinic (n = 177). Patient encounters in the residents’ teaching clinic after quality improvement intervention (n = 119) were reviewed and compared with pre-intervention data. Prior to intervention, fellows were significantly more likely to offer smoking cessation counseling (p = 0.024) and document spirometry showing airway obstruction (p < 0.001). Smoking cessation counseling, pneumococcal vaccination, and diagnosis of COPD by spirometry were targets for QI. A single-cycle, resident-led QI project was initiated. After, residents numerically improved in the utilization of spirometry (66.5% vs. 74.8%) and smoking cessation counseling (81.8% vs. 86.6%), and significantly improved rates of pneumococcal vaccination (p = 0.024). One cycle of resident-led QI significantly improved the rates of pneumococcal vaccination, with numerical improvement in other areas of COPD care.

scholarly journals Complexity of patients with chronic obstructive pulmonary disease hospitalized in internal medicine: a survey by FADOI

2015 ◽  
Vol 9 (2) ◽  
pp. 120 ◽  
Author(s):  
Carlo Nozzoli ◽  
Luigi Anastasio ◽  
Leonardo M. Fabbri ◽  
Pietro Marino ◽  
Roberto Nardi ◽  
...  
Keyword(s):  
Internal Medicine ◽  
Chronic Obstructive Pulmonary Disease ◽  
Pulmonary Disease ◽  
Prognostic Index ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Management Objectives ◽  
Copd Patients ◽  
The Mean ◽  
Comorbidity Status

Chronic obstructive pulmonary disease (COPD) is one of the most frequent pathologies among patients hospitalized in Internal Medicine (IM) Departments. COPD is frequently associated with concomitant diseases, which represent major causes of death, and affect disease management. Objectives of our study are to assess the prevalence of COPD patients in IM, to evaluate their comorbidity status, and to describe their complexity, by means of the validated multidimensional prognostic index (MPI) score. COMPLEXICO is an observational, prospective, multicenter study, enrolling consecutive patients hospitalized for any cause in IM, with diagnosis of COPD documented by spirometry. A total of 1002 patients in 43 IM Units in Italy were enrolled. The prevalence of COPD in IM was found to be 18.1%, and 72.8% of patients had at least three chronic diseases other than COPD. The mean MPI was 0.43±0.15, and according to a stratification algorithm 31.8% of patients were classified as having low-risk, 58.9% moderate-risk and 9.3% severe-risk of adverse outcome. More than two-thirds of COPD patients in our study present moderate to severe risk of poor outcome according to the MPI stratification.

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