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Objective: To investigate the reports provided for chronic obstructive pulmonary disease (COPD) patients by a certain pulmonologist board, and to determine their consistency with the recent national and international guidelines regarding diagnosis and management.
Design: One hundred and six valid official reports provided by physicians working in the chest department of a university hospital were evaluated retrospectively according to the information available on diagnostic criteria and treatment options.
Results: Mean age of the patients was 62± 11 years and 89% were males. Diagnostic information given in the reports included symptoms, physical signs, basic pulmonary function test results, bronchodilator test results, arterial blood gases, chest X-ray and thorax CT/HRCT findings (in 94.3%, 47.2%, 56.6%, 5.6%, 16%, 7.5% and 4.7% of the reports, respectively). Functional stage (FEV1 as percent of predicted) was declared in 49.1% of the reports. Therapeutic decisions included short-acting 32-agonists, long-acting |32-agonists, short-acting anticholinergics, inhaled steroids, theophylline, expectorants, oral steroids (when needed), antibiotics (when needed), cromones, anti-leukotrienes, nebulizers, long-term oxygen therapy and non-invasive mechanic ventilator (in 87.7%, 86.8%, 67%, 72.6%, 73.6%, 67%, 25.5%, 55.7%, 0.9%, 0.9%, 41.5%, 10.4% and 3.8% of the reports, respectively).
Conclusion: The diagnostic and therapeutic reports for COPD patients provided in our department reveal some inappropriateness in diagnosis and treatment according to the recent guidelines. Although it is not necessarily indicative of improper practical approach in drug prescription, the results may be accepted as a warning for the requirement of an urgent action plan on public health politics in Turkey.