6533b829fe1ef96bd128ae14
RESEARCH PRODUCT
Hospital Care of Older Patients With COPD: Adherence to International Guidelines for Use of Inhaled Bronchodilators and Corticosteroids
Marco ProiettiPasquale AgostiChiara LonatiCorrao SalvatoreFrancesco PerticonePier Mannuccio MannucciNobili AlessandroSergio HarariPier Mannuccio MannucciAlessandro NobiliMauro TettamantiLuca PasinaCarlotta FranchiSalvatore CorraoAlessandra MarengoniFrancesco SalernoMatteo CesariFrancesco PerticoneGiuseppe LicataFrancesco VioliGino Roberto CorazzaCarlotta FranchiLaura CortesiMauro TettamantiLaura CortesiIlaria ArdoinoDomenico PriscoElena SilvestriCaterina CenciGiacomo EmmiGianni BioloMichela ZanettiMartina GuadagniMichele ZaccariMassimo VanoliGiulia GrignaniEdoardo Alessandro PulixiMauro BernardiSilvia Li BassiLuca SantiGiacomo ZaccheriniElmo MannarinoGraziana LupattelliVanessa BianconiFrancesco PaciulloRanuccio NutiRoberto ValentiMartina RuvioSilvia CappelliAlberto PalazzuoliOliviero OlivieriDomenico GirelliThomas MatteazziMario BarbagalloLigia DominguezFloriana CocitaVincenza BeneduceLidia PlancesMarco ZoliIlaria LazzariMattia BrunoriFranco Laghi PasiniPier Leopoldo CapecchiGiuseppe PalascianoMaria Ester ModeoCarla Di GennaroMaria Domenica CappelliniDiletta MairaValeria Di StefanoGiovanna FabioSonia SeghezziMarta MancarellaMatteo CesariPaolo Dionigi RossiSarah DamantiMarta ClericiFederica ContiGino Roberto CorazzaEmanuela MiceliMarco Vincenzo LentiMartina PisatiCostanza Caccia DominioniGiovanni MurialdoAlessio MarraFederico CattaneoRoberto PontremoliMaria Beatrice SecchiDavide GhelfiLuigi AnastasioLucia SofiaMaria CarboneFrancesco CipolloneMaria Teresa GuagnanoErmanno AngelucciEmanuele ValerianiGerardo MancusoDaniela CalipariMosè BartoneGiuseppe DelitalaMaria BerriaMaurizio MuscaritoliAlessio MolfinoEnrico PetrilloGiuseppe ZuccalàGabriella D’aurizioGiuseppe RomanelliAlessandra MarengoniAlberto ZucchelliAntonio PicardiUmberto Vespasiani GentilucciPaolo GalloChiara Dell’untoGiorgio AnnoniMaurizio CorsiGiuseppe BellelliSara ZazzettaPaolo MazzolaHajnalka SzaboAlessandra BonfantiFranco ArturiElena SuccurroMariangela RubinoMaria Grazia SerraMaria Antonietta BleveLaura GasbarroneMaria Rosaria SajevaAntonio BrucatoSilvia GhidoniFabrizio FabrisIrene BertozziGiulia BogoniMaria Victoria RabuiniElisabetta CosiRoberto ManfrediniFabio FabbianBenedetta BoariAlfredo De GiorgiRuana TiseoGiuseppe PaolissoMaria Rosaria RizzoClaudio BorghiEnrico StrocchiValeria De SandoIlenia PareoCarlo SabbàFrancesco Saverio VellaPatrizia SuppressaPasquale AgostiAndrea SchilardiFrancesca LoparcoLuigi FenoglioChristian BraccoAlessia Valentina GiraudoSilvia FargionGiulia PeritiMarianna PorzioSlivia TiraboschiFlora PeyvandiRaffaella RossioBarbara FerrariGiulia ColomboValter MonzaniValeria SavojardoChristian FolliGiuliana CerianiFrancesco SalernoGiada PalliniFranco DallegriLuciano OttonelloLuca LiberaleLara CaserzaKassem SalamNicola Lucio LiberatoTiziana TogninGiovanni Battista BianchiSabrina GiaquintoFrancesco PurrelloAntonino Di PinoSalvatore PiroRenzo RozziniLina FalangaElena SpazziniCamillo FerrandinaGiuseppe MontrucchioPaolo PetittiRaffaella SalmiPiergiorgio GaudenziFrancesco VioliLudovica PerriRaffaele LandolfiMassimo MontaltoAntonio MirijelloLuigina GuastiLuana CastiglioniAndrea MarescaAlessandro SquizzatoMarta MolaroAlessandra GrossiMarco BertolottiChiara MussiMaria Vittoria LibbraGiulia DondiElisa PellegriniLucia CarulliFrancesco PerticoneLidia ColangeloTania FalboVincenzo StanghelliniRoberto De GiorgioEugenio RuggeriSara Del VecchioAndrea SalviRoberto LeonardiGiampaolo DamianiArmando GabrielliWilliam CapeciMassimo MattioliGiuseppe Pio MartinoLorenzo BiondiPietro PettinariRiccardo GhioAnna Dal ColSalvatore MinisolaLuciano ColangeloAntonella AfeltraBenedetta MariglianoMaria Elena PipitaPietro CastellinoJulien BlancoLuca ZanoliSamuele PignataroValter SaraccoMarisa FogliatiCarlo BussolinoFrancesca MeteMiriam GinoAntonio CittadiniCarlo VigoritoMichele ArcopintoAndrea SalzanoEmanuele BobbioAlberto M. MarraSirico DomenicoGuido MoreoFrancesca GaspariniSilvia ProloGloria PinaAlberto BallestreroFabio FerrandoSergio BerraSimonetta DassiMaria Cristina NavaBruno GraziellaStefano BaldassarreSalvatore FragapaniGabriella GrudenGiorgio GalantiGabriele MascheriniCristian PetriLaura StefaniMargherita GirinoValeria PiccinelliFrancesco NassoVincenza GioffrèMaria PasqualeGiuseppe ScattolinSergio MartinelliMauro TurrinLeonardo SechiCristina CatenaGianluca ColussiNicola PassarielloLuca RinaldiFranco BertiGiuseppe FamularoTarsitani PatriziaRoberto CastelloMichela PasinoGian Paolo CedaMarcello Giuseppe MaggioSimonetta MorgantiAndrea ArtoniStefano Del GiaccoDavide FirinuFrancesca LosaGiovanni PaolettiGiuseppe MontaltoAnna LicataValentina MalerbaLasco AntoninoGiorgio BasileCatalano AntoninoLorenzo MalatinoBenedetta StancanelliValentina TerranovaSalvatore Di MarcaPatrizia MecocciCarmelinda RuggieroVirginia BoccardiTiziana MeschiFulvio LauretaniAndrea TicinesiPietro MinuzLuigi FondrieschiMario PirisiGian Paolo FraDaniele SolaMassimo PortaPiero RivaRoberto QuadriGiorgio ScanziCaterina MengoliStella ProviniLaura RicevutiEmilio SimeoneRosa ScurtiFabio TollosoRoberto TarquiniAlice ValorianiSilvia DolentiGiulia VanniniAlberto TedeschiLucia TrottaRiccardo VolpiPietro BocchiAlessandro VignaliSergio HarariChiara LonatiMara Cattaneosubject
Malemajor clinical eventmajor clinical eventsPulmonary Disease Chronic Obstructive0302 clinical medicineOlder patientsAdrenal Cortex Hormones80 and over030212 general & internal medicineLS4_4adherenceProspective StudiesGeneral NursingNursing (all)2901 Nursing (miscellaneous)Aged 80 and overCOPDHealth PolicyGeneral MedicineCOPD guidelines adherence major clinical events older patientsolder patientsObstructive lung diseaseBronchodilator Agentsguidelines adherenceHospitalizationInhalationCOPD; guidelines adherence; major clinical events; older patients; Administration Inhalation; Adrenal Cortex Hormones; Aged; Aged 80 and over; Bronchodilator Agents; Female; Humans; Male; Prospective Studies; Pulmonary Disease Chronic Obstructive; Guideline Adherence; HospitalizationAdministrationFemaleGuideline AdherenceCOPD guidelinesCOPD; guidelines adherence; major clinical events; older patients; Nursing (all)2901 Nursing (miscellaneous); Health Policy; Geriatrics and GerontologyChronic Obstructivemedicine.medical_specialtySocio-culturalePulmonary Disease03 medical and health sciencesolder patientInternal medicineAdministration InhalationmedicineHumansCOPDMedical prescriptionAgedPolypharmacybusiness.industrySettore MED/09 - MEDICINA INTERNAOdds ratiomedicine.diseaseConfidence intervalrespiratory tract diseasesCOPD; guidelines adherence; major clinical events; older patientsObservational studyGeriatrics and Gerontologybusiness030217 neurology & neurosurgerydescription
Abstract Objectives We aimed to analyze the prevalence and impact of COPD in older patients hospitalized in internal medicine or geriatric wards, and to investigate adherence to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines, associated clinical factors, and outcomes. Design Data were obtained from REgistro POliterapie SIMI (REPOSI), a prospective multicenter observational registry that enrolls inpatients aged ≥65 years. Setting and Participants Older hospitalized patients enrolled from 2008 to 2016 with a diagnosis of COPD. Measures We evaluated adherence to the 2018 GOLD guidelines at admission and discharge, by examining the prescription of inhaled bronchodilators and corticosteroids in COPD patients. We also evaluated the occurrence of outcomes and its association with COPD and guideline adherence. Results At hospital admission, COPD was diagnosed in 1302 (21.5%) of 6046 registered patients. COPD patients were older, with more impaired clinical and functional status and multiple comorbidities. Overall, 34.3% of COPD patients at admission and 35.6% at discharge were adherent to the GOLD guidelines. Polypharmacy (≥5 drugs) at admission [odds ratio (OR): 3.28, 95% confidence interval (CI): 2.24-4.81], a history of acute COPD exacerbation (OR: 2.65, 95% CI: 1.44-4.88) at admission, smoking habit (OR: 1.45, 95% CI: 1.08-1.94), and polypharmacy at discharge (OR: 6.76, 95% CI: 4.15-11.0) were associated with adherence to guidelines. COPD was independently associated with the risk of cardiovascular and respiratory death and rehospitalization occurrence compared to patients without COPD during follow-up. Adherence to guidelines was inversely associated with the occurrence of death from all causes (OR: 0.12, 95% CI: 0.02-0.90). Conclusions/Implications COPD was common in older patients acutely hospitalized, showing an impaired functional and clinical status. Prescriptions for older COPD patients were often not adherent to GOLD guidelines. Poor adherence to guidelines was associated with a worse clinical status. There is a need to improve adherence to guidelines in treating COPD patients, with the ultimate goal of reducing clinical events.
| year | journal | country | edition | language |
|---|---|---|---|---|
| 2019-01-01 |