Optimizacija terapije odrzavanja HOBP

OPTIMIZACIJA TERAPIJE ODRAVANJA HOBPGradski zavod za plune bolesti i tuberkulozuBeograddr Dejan ujoviOvo izlaganje je sponzorisano od strane Boehringer Ingelheim

Predava za: AstraZeneca, GSK, Boehringer Ingelheim, Takeda, MSD, Sanofi Pasteur, Pfizer, Merck Studijski istraiva za: GSK, Boehringer Ingelheim, AstraZeneca, MSD

Konflikt interesa# Lekari e morati da prihvate svoju odgovornost za upravljanje resursima, a ne samo za njihovu upotrebu.OPTIMIZACIJA?Sir Muir Gray BMJ Oct 6 2012 #WORK PROGRESS EXPLANATIONADHERENCA

Ima li vrlo esto propisivanje razliitih tipova inhalera negativan uticaj na redovnost upotrebe inhalacione terapije? Kakve reime leenja preferiraju nai pacijenti?ABCDBEZBEDNOST

Da li iroka upotreba vrlo visokih doza ICS u terapiji HOBP moe da ima bezbedonosne rizike?

CENA

Da li optimizacija leenja moe pozitivno da utie na cenu leenja? Koliko je est overtreatment i koliko on kota pacijenta i zajednicu?

DOBRA KLINIKA PRAKSA

Da li smernice za leenje HOBP moemo posmatrati i kroz ekonomsku komponentu? Koliko se zaista rukovodimo vodiima dobre klinike prakse?#Cena respiratorne terapijeProsena neto cena po jedinici ()2010.Source: NHS Information Centre#TERAPIJA HOBP BEZ UPORITA U GOLD PREPORUKAMAJochmann A, et al. Swiss Med Wkly. 2012;142:w13567#SummaryPRINCIPLES: The Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines aim to optimise chronic obstructive pulmonary disease (COPD) diagnosis and treatment.However, little is known about the extent to which general practitioners (GP) adherence to GOLD guidelines improves patient outcomes.METHODS: In this questionnaire-based study, COPD patients were screened and enrolled; exacerbation history was recorded, and demographic, spirometric and management data were collected for 12 months. Spirometry was performed at least every 6 months according to American Thoracic Society guidelines. Based on these data, patients were grouped into GOLD COPD severity classifications. Data were expressed as the difference between baseline and month 12.RESULTS: Among 139 GPs, 454 patients were analysed regarding baseline and 12 month data. There was no significant change in distribution of GOLD COPD severity grades, lung function or guideline adherence. Chronic cough and sputum production were significantly reduced (p