RECOMMENDATIONS ON COPD AND FAMILY PRACTITIONERS: WHAT IS THE LEVEL OF ADHERENCE?

Y. M. Mostovoy, T. V. Konstantinovych, O. R. Lindiuk, O. V. Bugaichuk Abstract Majority of COPD patients should receive medical care provided by family practitioners. Only the cases of severe, uncontrolled diseases must be managed by pulmonologists. That is why family practitioners must be well informed on actual requirements on diagnosis and treatment of COPD in order to give effective care to this population of patients. Following the aim to study quality of medical care, provided to COPD patients by family practitioners, we analyzed 220 out-patient records (95 men (43,2 %), 125 women (56,8 %); mean age 69 years). Analyzing medical records the attention was mainly focused at two issues — accuracy of diagnosis formulation and correctness of treatment prescription. It was revealed that the clinical group of disease was not mentioned in 107 (48,6 %) patients. This made impossible to prescribe maintenance treatment correctly. Long-acting anticholinergic drugs and it combinations were prescribed unreasonably rarely (11 (5 %) vs needed 97 (44,1 %) cases). On the contrary, short-acting bronchodilators (salbutamol, berodual monotherapy) and inhaled corticosteroid/long-acting beta 2 agonist combination were used in 51 (23,2 %) and 50 (22,7 %) cases, respectively. Among them 48 (48,9 %) patients required hospitalization, use of antibiotics and systemic corticosteroids. This is mainly explained by incorrect use of maintenance therapy for COPD. The authors conclude about low adherence of family practitioners to state and international COPD guidelines. Further work is needed to increase the knowledge of physician regarding COPD diagnosis and treatment along with active consultancy of out-patient facilities by the pulmonologists.

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Audit in psychiatry

Psychiatric Bulletin ◽

10.1192/pb.13.6.278 ◽

1989 ◽

Vol 13 (6) ◽

pp. 278-281 ◽

Cited By ~ 13

Author(s):

Gillian Garden ◽

Femi Oyebode ◽

Stuart Cumella

Keyword(s):

Quality Of Life ◽

Medical Care ◽

Critical Analysis ◽

White Paper ◽

Diagnosis And Treatment ◽

Medical Audit ◽

Use Of Resources ◽

Quality Of Medical Care ◽

The Government

Medical audit has been defined as the systematic, critical analysis of the quality of medical care, including the procedures used for diagnosis and treatment, the use of resources and the resulting outcome and quality of life for the patient (DOH, 1989). The White Paper Working for Patients states that the Government proposes that every consultant should participate in a form of medical audit agreed between management and the profession locally. It also states that management should be able to initiate an independent professional audit.

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FROM IDIOPATHIC FIBROSING ALVEOLITIS TO IDIOPATIC LUNGS FIBROSIS

Clinical Practice ◽

10.17816/clinpract7373-76 ◽

2016 ◽

Vol 7 (3) ◽

pp. 73-76 ◽

Cited By ~ 1

Author(s):

A V Averyanov

Keyword(s):

Idiopathic Pulmonary Fibrosis ◽

Pulmonary Fibrosis ◽

Medical Care ◽

Diagnosis And Treatment ◽

Fibrosing Alveolitis ◽

Current State ◽

Quality Of Medical Care

In this paper we try to present the current state of knowledge of the diagnosis and treatment of idiopathic pulmonary fibrosis (IPF), and to express our view on the problems and their solution, without which it is very difficult to improve the quality of medical care for IPF-patients in Russia.

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Psychiatric audit

Psychiatric Bulletin ◽

10.1192/pb.15.9.550 ◽

1991 ◽

Vol 15 (9) ◽

pp. 550-551 ◽

Cited By ~ 4

Author(s):

Paul Hatton ◽

Edward B. Renvoize

Keyword(s):

Quality Of Life ◽

Medical Care ◽

Critical Analysis ◽

Diagnosis And Treatment ◽

Medical Audit ◽

Department Of Health ◽

Use Of Resources ◽

Quality Of Medical Care ◽

Patient Department

Medical audit has been defined “as the systematic, critical analysis of the quality of medical care, including the procedures used for diagnosis and treatment, the use of resources, and the resulting outcome and quality of life for the patient” (Department of Health, 1989).

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MedPAC Efficiency Study to Assess Quality of Medical Care

Internal Medicine News ◽

10.1016/s1097-8690(05)72313-1 ◽

2005 ◽

Vol 38 (21) ◽

pp. 84

Author(s):

JENNIFER LUBELL

Keyword(s):

Medical Care ◽

Quality Of Medical Care ◽

Assess Quality

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Responsibility for a quality of medical care provided via telemedicine

Journal of Telemedicine and E-Health ◽

10.29188/2542-2413-2018-4-1-2-9-15 ◽

2018 ◽

Vol 2018 (1-2) ◽

pp. 9-15

Author(s):

Morozov S.P. ◽

◽

Vladzymyrskyy A.V. ◽

Varyushin M.S. ◽

Aronov A.V. ◽

...

Keyword(s):

Medical Care ◽

Quality Of Medical Care

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METHODOLOGICAL APPROACH TO EVALUATING THE EFFECTIVENESS OF RESOURCE USE BY MEDICAL ORGANIZATIONS

EKONOMIKA I UPRAVLENIE: PROBLEMY, RESHENIYA ◽

10.36871/ek.up.p.r.2020.07.03.007 ◽

2020 ◽

Vol 3 (7) ◽

pp. 62-69

Author(s):

S. S. BUDARIN ◽

Keyword(s):

Medical Care ◽

Resource Use ◽

Methodological Approach ◽

Use Of Resources ◽

Quality Of Medical Care ◽

Methodological Approaches ◽

Performance Audit ◽

Available Resources

The article reveals methodological approaches to evaluating the effectiveness of the use of resources of medi-cal organizations in order to improve the availability and quality of medical care based on the application of the methodology of performance audit; a methodological approach to the use of individual elements of the efficiency audit methodology for evaluating the performance of medical organizations and the effectiveness of the use of available resources is proposed.

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Evaluation of medical care for Diabetic and Hypertensive patients in primary care in Mexico: Observational retrospective study (Preprint)

10.2196/preprints.24720 ◽

2020 ◽

Author(s):

Agustin Lara-Esqueda ◽

Sergio A Zaizar-Fregoso ◽

Violeta M Madrigal-Perez ◽

Mario Ramirez-Flores ◽

Daniel A Montes-Galindo ◽

...

Keyword(s):

Diabetes Mellitus ◽

Medical Care ◽

Serum Lipids ◽

Quality Care ◽

Premature Death ◽

Current Standard ◽

Anonymized Data ◽

Quality Of Medical Care

BACKGROUND Diabetes Mellitus is a worldwide health problem and the leading cause of premature death with increasing prevalence over time. Usually, along with it, Hypertension presents and acts as another risk factor that increases mortality risk. Both diseases impact the country's health while also producing an economic burden for society, causing billions of dollars to be invested in their management. OBJECTIVE The present study evaluated the quality of medical care for patients diagnosed with diabetes mellitus (DM), hypertension (HBP), and both pathologies (DM+HBP) within a public health system in Mexico, according to the official Mexican standard for each pathology. METHODS 45,498 patients were included from 2012 to 2015. All information was taken from the electronic medical records database, exported as anonymized data for research purposes. Each patient record was compared against the standard to test the quality of medical care. RESULTS Glycemia with hypertension goals reached 29.6% in DM+HBP, 48.6% in DM, and 53.2% in HBP. The goals of serum lipids were reached by 3% in DM+HBP, 5% in DM, and 0.2% in HBP. Glycemia, hypertension, and LDL cholesterol reached 0.04%. 15% of patients had an undiagnosed disease of diabetes or hypertension. Clinical follow-up examinations reached 20% for foot examination and clinical eye examination in the whole population. Specialty referral reached 1% in angiology or cardiology in the whole population. CONCLUSIONS Goals for glycemic and hypertension reached 50% in the overall population, while serum lipids, clinical follow-up examinations, and referral to a specialist were deficient. Patients who had both diseases had more consultations, better control for hypertension and lipids, but inferior glycemic control. Overall, quality care for DM and/or HBP has not been met according to the standards. While patients with DM and HBP do not have a current standard to evaluate their own needs.

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