Description of the profile of A patient with initial diagnosis of chronic obstructive pulmonary disease

Objectives: The purpose of this study was to analyse the clinical situation of the patient diagnosed with COPD, to determine the variables that will have the most influence for good management of the disease both by the physician and patient, and to reinforce adherence to the treatment.

Material and methods: Descriptive observational study involving 50 patients referred to a specialized Pneumology office, where they were diagnosed with COPD. We collected socio-demographic, clinical, functional, and treatment adherence variables (Morisky-Green and Haynes-Sackett test).

Results: According to the GOLD classification of COPD, 12% were mild, 68% moderate, 14% severe and 6% very severe. Mean age was 66 ± 8.4 years. 60% of patients came accompanied by their partner (there were no significant differences between this fact and coming alone or accompanied by other family members, in terms of smoking, adherence or vaccinations). 32 (64%) were active smokers, and 36% ex-smokers (mean 7.1 ± 9.3 years). 24 patients had a flu vaccine but only 3 (6%) were vaccinated for pneumococcus.

Of the 50 patients, 15 (30%) had never received inhalers, while of those who were using them or had received them at some time (70%), 18% had not received instructions in their use. The type of inhaler most frequently prescribed to these patients was the dry powder and beta-agonists in the MDI system. When inhaler techniques were checked, only 6 (17%) did not make any technical error, being two the most frequent number of errors.

Of the total, 16 (32%) were not good compliers (failed at least one item). The most frequent response was that they stopped taking medication when they were feeling fine (10 patients, 20%), followed by forgetfulness (9 patients, 18%). In assessing only those patients (35) who were already taking inhalers at the time of the consultation, 12 of them (34%) were non-compliant. The Haynes-Sackett test only showed failure in three patients (6%).

Conclusions: More than half of the COPD cases were already moderate (GOLD classification) at the time of diagnosis, active smokers comprising 64% of the total. 30% of patients did not have a good compliance, the most frequent cause being stopping medication when clinically stable. In addition, some patients made mistakes in the inhalation technique. There was also a low rate of recommended vaccinations.