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Adherence to COPD Treatment Guidelines Varies by Hospital

Fewer than 10 percent of chronic obstructive pulmonary disease patients at some hospitals receive recommended care

FRIDAY, June 23 (HealthDay News) -- Despite the presence of evidence-based, well-accepted guidelines for acute care of chronic obstructive pulmonary disease (COPD) exacerbations, treatment adherence varies by hospital and is often low, according to a report in the June 20 issue of the Annals of Internal Medicine.

Peter K. Lindenauer, M.D., M.Sc., from Baystate Medical Center and Tufts University School of Medicine in Springfield, Mass., and colleagues conducted a retrospective cohort study to evaluate the quality of care for 69,820 patients hospitalized for acute exacerbations of COPD at 360 hospitals and to determine if care varied by hospital.

Of the treatments recommended by the American College of Physicians and the American College of Chest Physicians, adherence ranged from 95 percent for chest radiography to 85 percent for both systemic steroid and antibiotic use. Numerous patients received treatments that are viewed as not beneficial including methylxanthine bronchodilators (24 percent) and sputum testing (14 percent). In some hospitals, fewer than 10 percent of patients received ideal care while in others more than 60 percent received ideal care.

"The quality of care for patients hospitalized for acute exacerbations of COPD may be improved by increasing the use of systemic corticosteroid and antibiotic therapy, decreasing the use of unnecessary and potentially harmful treatments, and reducing variation in practice across hospitals," the authors conclude.

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