Are We Following Evidence-Based Guidelines for the Treatment of Acute COPD Exacerbations at University Hospital?

Abstract

The World Health Organization estimates the third leading cause of death worldwide is Chronic Obstructive Pulmonary Disease (COPD). In 2019, COPD caused 3.23 million deaths, of which 80% occurred in low- and middle-income areas. Costs attributable to having COPD were $32.1 billion in 2010 with a projected increase to $49.0 billion by 2020. The purpose of this study was to identify the compliance with evidence-based guidelines for the treatment of acute COPD exacerbations at University Hospital.

Our results indicated the best compliance with admission chest x rays with a rate of correctly performed of 98% (94.1,101.9%). Following that, was the use of inhaled anticholinergic bronchodilators and inhaled short acting beta agonists with a rate of 92% (84.5, 99.5%). There was a nearly identical compliance rate observed for use of noninvasive positive pressure ventilation at 84% (73.8, 94.2%) and use of narrow spectrum antibiotic at 86% (76.4, 95.6%). And significant drops were noted in the compliance rate of avoiding mucolytic medications, chest physiotherapy, or methylxanthine bronchodilators at 74% (61.8, 86.2%) and with the compliance rate of use of systemic corticosteroids for 5 to 14 days with a rate of 54.0% (40.2, 67.8%).

Despite achieving high quality adherence in certain aspects of COPD care, our findings suggest the need for additional training in the care of COPD exacerbations.