Abstract
Aim: To assess the rehabilitation quality of disabled due to COPD.
Methods: we analyzed medical records of 98 disabled due to COPD from different Ukrainian regions, mostly from countryside, average age 55.4 ± 1.2 yrs, 75.5% male, 47.9% miners, 71% with COPD stage III, 29% - stage IV.
Results: Most disabled due to COPD were men up to 60 yrs. In 38.5% patients COPD was first diagnosed in more than 5-10 years after the onset of clinical symptoms. Only in rare cases was performed a post-bronchodilator pulmonary function testing. Among bronchodilators, assigned to the patients, prevails salbutamol (63.1%). Nevertheless, inhaled corticosteroids were assigned adequately, in mostly cases it was fluticasone propionate combinated with salmeterol - 73.7%. However, modern anticholinergics (tiotropium bromide and ipratropium bromide combined with fenoterol) were assigned in only 42.1% cases. Not enough attention is paid to treatment of comorbidity, especially cardiovascular diseases; often were used drugs affecting the bronchopulmonary system (e.g., Β-blockers with low cardioselectivity (metoprolol) and ACE inhibitors). None of disabled patients received physical rehabilitation techniques aimed at respiratory myopathy correcting; not enough attention paid to nutritional status of patients, even in those with a body mass index less than 19.5.
55.6% patients received only drug rehabilitation; integrated approach to the rehabilitation of COPD patients using the drugs, dietary recommendations, physical therapy barely used. So, late diagnosis of lung disease, in turn, leads to delays in the appointment of bronchodilators, anti-inflammatory and other therapies and as a result, the disease burden and disability increase.
- Copyright ©the authors 2016
