Recursos disponibles para el manejo de la agudización de la enfermedad pulmonar obstructiva crónica en España

  1. J.J. Soler-Cataluña 1
  2. A. Fernández Villar 2
  3. P.l. Piñera Salmerón 3
  4. M. Román-Rodríguez 4
  5. A. Huerta Hernández 5
  6. M. Roset Gamisans 6
  1. 1 Hospital de Arnau de Vilanova-Lliria, Valencia, España
  2. 2 Hospital Álvaro Cunqueiro, Instituto de Investigación Biomédica Galicia Sur, Vigo, Pontevedra, España
  3. 3 Hospital General Universitario Reina Sofía, Murcia, España
  4. 4 Centro de Salud Son Pisà, Palma, Islas Baleares, España
  5. 5 GlaxoSmithKline, Madrid, España
  6. 6 Health Economics and Outcomes Research, IQVIA, Barcelona, España
Revista:
Semergen: revista española de medicina de familia

ISSN: 1138-3593

Ano de publicación: 2018

Número: 7

Páxinas: 449-457

Tipo: Artigo

DOI: 10.1016/J.SEMERG.2018.03.010 DIALNET GOOGLE SCHOLAR

Outras publicacións en: Semergen: revista española de medicina de familia

Resumo

Objective Chronic obstructive pulmonary disease exacerbations (COPDE) lead to a high use of healthcare resources. This study assesses the healthcare and organisational resources of Spanish health care centres for the management of COPDE at different care levels (Primary Care (PC), Respiratory Diseases, Internal Medicine, and Emergency Departments), and compare with current recommendations. Material and methods An observational study was carried out through telephone interviews to General Practitioners, Chest Diseases, Internal Medicine, and Emergency Department doctors. Results A total of 284 doctors were interviewed. According to their responses, at PC centres there is a high availability of pulse oximetry (98.9%) and electrocardiograph (100%), and a low availability of Chest X-Ray (19.1%), or urgent laboratory tests (17.0%) in sites. In hospital wards, non-invasive mechanical ventilation (NIV) availability was 76.1%, with only a 69.7% of nursing staff properly trained in its use. Respiratory intermediate care units (RICUs) were available in 18.3% of public hospitals versus 41.7% of private hospitals. Specific training for COPDE management was received by 47.9% of Emergency Department doctors in the previous year. Only 31.9% of PC centres had specific protocols for referring patients to specialists. More than 35% of PC centres and hospitals do not have their electronic medical records integrated with other healthcare levels. Conclusions In general terms, there are sufficient resources available in Spanish healthcare centres. However, several areas of improvement were identified, such as an insufficient level of electronic medical record integration between healthcare levels, limited implementation of RICUs in public hospitals, and deficiencies related to specific training in NIV management.

Referencias bibliográficas

  • M. Miravitlles, J.J. Soler-Cataluña, M. Calle, J. Molina, P. Almagro, J.A. Quintano, et al. Guía de Práctica Clínica para el Diagnóstico y Tratamiento de Pacientes con Enfermedad Pulmonar Obstructiva Crónica (EPOC) - Guía Española de la EPOC (GesEPOC) Arch Bronconeumol, 48 (Suppl 1) (2012), pp. S2-S58 Google Scholar
  • J.J. Soler-Cataluña, M.A. Martínez-García, P. Román Sánchez, E. Salcedo, M. Navarro, R. Ochando Severe acute exacerbations and mortality in patients with chronic obstructive pulmonary disease Thorax, 60 (2005), pp. 925-931 CrossRefView Record in ScopusGoogle Scholar
  • A. Sicras, A. Huerta, R. Navarro, J. Ibáñez Use of resources and associated costs of chronic obstructive pulmonary disease exacerbations: A population based retrospective study Semergen, 40 (2014), pp. 189-197 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • Aguilar PM. Atención de pacientes con Enfermedad Pulmonar Obstructiva Crónica agudizada en urgencias. Criterios de ingreso en la UCE. Gobierno de la Rioja. Hospital San Pedro. Servicio de Urgencias. Protocolos [consultado 2 Sep 2015] Disponible en: https://www.riojasalud.es/f/old/ficheros/protocolo_epoc.pdf Google Scholar
  • F. Pozo-Rodríguez, J.L. López-Campos, C.J. Álvarez-Martínez, A. Castro-Acosta, R. Agüero, J. Hueto, et al., AUDIPOC Study Group Clinical Audit of COPD Patients Requiring Hospital Admissions in Spain: AUDIPOC Study PLoS One, 7 (2012), p. e42156 CrossRefView Record in ScopusGoogle Scholar
  • F. Pozo-Rodríguez, A. Castro-Acosta, C.J. Alvarez, J.L. López-Campos, A. Forte, A. López-Quilez, et al. Determinants of between-hospital variations in outcomes for patients admitted with COPD exacerbations: Findings from a nationwide clinical audit (AUDIPOC) in Spain Int J Clin Pract, 69 (2015), pp. 938-947 CrossRefView Record in ScopusGoogle Scholar
  • J. Escarrabill, E. Torrente, C. Esquinas, C. Hernández, E. Monsó, M. Freixas, et al. Auditoría clínica de los pacientes que ingresan en el hospital por agudización de EPOC. Estudio MAG-1 Arch Bronconeumol, 51 (2015), pp. 483-489 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • S. Hartl, J.L. Lopez-Campos, F. Pozo-Rodriguez, A. Castro-Acosta, M. Studnicka, B. Kaiser, et al. Risk of death and readmission of hospital-admitted COPD exacerbations: European COPD Audit Eur Respir J, 47 (2016), pp. 113-121 CrossRefView Record in ScopusGoogle Scholar
  • Soler Cataluña JJ, Fernández Villar A, Román Rodríguez M, Ancochea Bermúdez J. Proceso Asistencial Integrado del Paciente con EPOC exacerbado (PACEX-EPOC) [consultado 2 Sep 2015] Disponible en: http://issuu.com/separ/docs/pai_pacex-epoc?e=3049452/13909603 Google Scholar
  • González López-Valcárcel B, Barber Pérez P. Oferta y necesidad de médicos especialistas en España (2006-2030) [consultado 2 Sep 2015] Disponible en: http://www.msc.es/novedades/docs/necesidadesEspeciales06_30.pdf Google Scholar
  • J. De Miguel Díez, J.L. Izquierdo Alonso, J. Molina París, J.M. Rodríguez González-Moro, P. de Lucas Ramos, G. Gaspar Alonso-Vega Fiabilidad del diagnóstico de la EPOC en atención primaria y neumología en España. Factores predictivos Arch Bronconeumol, 39 (2003), pp. 203-208 ArticleDownload PDFView Record in ScopusGoogle Scholar
  • K. Krigsman, J.L. Nilsson, L. Ring Refill adherence for patients with asthma and COPD: Comparison of a pharmacy record database with manually collected repeat prescriptions Pharmacoepidemiol Drug Saf, 16 (2007), pp. 441-448 CrossRefView Record in ScopusGoogle Scholar
  • D.A. Kaminsky, T.W. Marcy, M. Bachand, C.G. Irvin Knowledge and use of office spirometry for the detection of chronic obstructive pulmonary disease by primary care physicians Respir Care, 50 (2005), pp. 1639-1648 View Record in ScopusGoogle Scholar
  • M.A. Puhan, E. Gimeno-Santos, M. Scharplatz, T. Troosters, E.H. Walters, J. Steurer Pulmonary rehabilitation following exacerbations of chronic obstructive pulmonary disease Cochrane Database Syst Rev (2011), p. CD005305 View Record in ScopusGoogle Scholar
  • G. Miranda, A. Gómez, E. Pleguezuelos, L. Capellas, en nombre de la Sociedad Española de Rehabilitación Cardiorrespiratoria (SORECAR) Rehabilitación respiratoria en España. Encuesta SORECAR Rehabilitacion, 45 (2011), pp. 247-255 ArticleDownload PDFView Record in ScopusGoogle Scholar