Survey on the Current Status of Chronic Obstructive Pulmonary Disease and Asthma Management in Jiangxi Province
Objective To understand the current status of chronic obstructive pulmonary disease(COPD)and asthma management in Jiangxi Province so as to optimize the management process for chronic respiratory diseases.Methods In July 2022,an online questionnaire survey was conducted among the heads of respiratory and critical care departments in 52 secondary and tertiary hospitals in Jiangxi Province,covering the number of COPD and asthma visits,the implementation of pulmonary function medical technology projects,common maintenance inhalation medications for stable COPD/asthma,and the use of patient condition assessment tools during the period from May 2021 to May 2022.Results All 52 questionnaires were valid,with 44.2%(23/52)from tertiary hospitals and 55.8%(29/52)from secondary A-level hospitals.The average monthly outpatient visits for COPD and asthma patients were 286 and 48,respectively.Pulmonary function tests were conducted in 49 hospitals(94%),with 11 hospitals(21%,11/52)equipped with dedicated pulmonary function physicians;38 hospitals(73.1%,38/52)had clinicians or nurses who also performed pulmonary function tests.25 hospitals(48%,25/52)utilized standardized questionnaires such as the COPD Assessment Test(CAT),Modified Medical Research Council Dyspnea Scale(mMRC),St.George's Respiratory Questionnaire(SGRQ),and Asthma Control Test(ACT)to evaluate the condition of patients with COPD or asthma.The implementation rates of complete lung function tests,provocation tests,bronchodilator tests,and fractional exhaled nitric oxide(FENO)tests in secondary hospitals were significantly lower than those in tertiary hospitals(P＜0.05).The overall implementation rate of provocation tests in Jiangxi Province was extremely low(13%).Over 80%of hospitals could prescribe common maintenance inhalation medications,with 57%(13/23)tertiary hospitals offering 6-8 types of inhalation medications for stable COPD/asthma and 62%(18/29)secondary hospitals offering 5-7 types.Both secondary and tertiary hospitals were equipped with ICS/LABA medications.However,the availability of dual bronchodilators(LABA/LAMA)(17%compared to 61%)and triple therapy(LABA/LAMA/ICS)(59%compared to 87%)was lower in secondary hospitals compared to tertiary hospitals(P＜0.05);the proportion of LABA medications in secondary hospitals was higher than that in tertiary hospitals(52%compared to 26%,P＜0.05).35 hospitals(67%,35/52)believed that patients'insufficient understanding of the disease would affect the management of COPD and asthma.Additionally,clinicians from all 52 hospitals would recommend patients to apply for medical insurance for respiratory chronic diseases,while doctors from 33 hospitals(64%,33/52)had concerns about the assessment of the proportion of chronic disease medications in outpatient prescriptions,potentially influencing decision-making regarding chronic disease prescriptions.Conclusion There is a significant demand for the management of COPD and asthma,and the overall diagnosis and treatment level of COPD and asthma in secondary hospitals needs to be improved.Improving pulmonary function testing services,enhancing the skills of respiratory specialists,ensuring sufficient supply of essential therapeutic drugs,and strengthening patient education and awareness can effectively contribute to the improved management of COPD and asthma,thereby enhancing patients'quality of life.
chronic obstructive pulmonary diseaseasthmacurrent status of managementJiangxi Province
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