COPD: Barriers to Effective Management

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Authors
Gallagher, Abby
Bredenkamp, Nancy
Augustyn, Brittany
Kuehn, Shannon
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2014-01-30
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Poster
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Chronic Obstructive Pulmonary Disease (COPD) is increasing in prevalence and is the third leading cause of death in the world (GOLD, 2011). Diagnosis and effective management of COPD is difficult for providers resulting in high healthcare utilization and increased cost (Mannino & Braman, 2007; Mapel, Dutro, Marton, Woodruff, & Make, 2011). To provide quality care to patients with COPD, primary care providers must be aware of and address barriers to management such as effective medication management, adherence to treatment programs, and utilization of evidence-based guidelines. This study assessed provider knowledge regarding current COPD guidelines and identified barriers experienced by the providers with treatment plan development, patient education, and patient adherence when caring for patients currently or newly diagnosed with COPD in urban and rural primary care clinics.|Subjects consisted of 25 providers from eight primary care clinics in Nebraska. Participants completed a 13 question COPD Management Survey and participation was voluntary. Results found 84% of providers utilized a guideline but only 28% always used spirometry to establish diagnosis. During management 92% assessed anxiety and 40% assessed inhaler technique. Eighty-five percent of Nurse Practitioners used more than two forms of education compared to 33% of Physicians and Physician Assistants. One hundred percent of providers felt smoking and cost of medications are barriers that affect patient adherence. Overall, this pilot study found despite provider use of guidelines, there are concerns with guideline compliance. Several barriers to patient adherence were identified yet some providers may not address these in practice. Future research might include provider education regarding guidelines, exploring the mid-level’s role in the management of COPD, and development of educational methods to address these patients’ needs.
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