Amrita Sarkar1, Abhay Javia2, Pradeep Pithadia3, Dipesh Parmar4. 1. Senior Resident, Department of Community Medicine, NEIGRIHMS, Shillong, Meghalaya, India. 2. Consultant Pulmonologist, Department of Pulmonology, Sterling Hospital, Rajkot, Gujarat, India. 3. Assistant Professor, Department of Community Medicine, Shri MP Shah Govt. Medical College, Jamnagar, Gujarat, India. 4. Professor and Head, Department of Community Medicine, Shri MP Shah Govt. Medical College, Jamnagar, Gujarat, India.
Abstract
INTRODUCTION: Chronic Obstructive Pulmonary Disease (COPD), a progressive respiratory illness requiring long-term treatment, is a significant cause of morbidity, mortality and economic burden on the family as well as the country. In the tertiary health care facility where the study was carried out, it was observed that many COPD patients did not come for regular follow up. In these patients, treatment interruption may lead to increased morbidity and mortality. AIM: This study aimed to find out the reasons for defaulting follow up and treatment in COPD patients. MATERIALS AND METHODS: All patients of COPD, attending TB Chest outpatient department during the study period (September 2012 to February 2013), were classified into Group A, B, C, and D according to latest Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Data was collected on patient's sociodemographic profile, severity of disease and reasons for defaulting follow up and treatment using pre-tested semi-structured questionnaires, patient history and clinical examination. Data obtained were entered in Microsoft Office Excel 2007 and analysed using Chi-square test. RESULTS: The mean age of the 200 patients recruited was 59.3 years. A total of 87% patients were male. Patients belonging to Group A, B, C and D were 11%, 25.5%, 41.5% and 22% respectively. Overall, 32% patients were defaulters. Three main reasons for default were non-affordability for treatment expenses (39.07%), resolution of symptoms (26.56%), and too ill to come (18.75%). The associations between default rate and demographic variables like age and gender were found statistically significant. CONCLUSION: Default rate among COPD patients is significantly associated with GOLD Group A and D, patient's income and patient literacy level. Main reasons for default were non-affordability of treatment expenses, too ill to come and resolution of symptoms.
INTRODUCTION:Chronic Obstructive Pulmonary Disease (COPD), a progressive respiratory illness requiring long-term treatment, is a significant cause of morbidity, mortality and economic burden on the family as well as the country. In the tertiary health care facility where the study was carried out, it was observed that many COPDpatients did not come for regular follow up. In these patients, treatment interruption may lead to increased morbidity and mortality. AIM: This study aimed to find out the reasons for defaulting follow up and treatment in COPDpatients. MATERIALS AND METHODS: All patients of COPD, attending TB Chest outpatient department during the study period (September 2012 to February 2013), were classified into Group A, B, C, and D according to latest Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Data was collected on patient's sociodemographic profile, severity of disease and reasons for defaulting follow up and treatment using pre-tested semi-structured questionnaires, patient history and clinical examination. Data obtained were entered in Microsoft Office Excel 2007 and analysed using Chi-square test. RESULTS: The mean age of the 200 patients recruited was 59.3 years. A total of 87% patients were male. Patients belonging to Group A, B, C and D were 11%, 25.5%, 41.5% and 22% respectively. Overall, 32% patients were defaulters. Three main reasons for default were non-affordability for treatment expenses (39.07%), resolution of symptoms (26.56%), and too ill to come (18.75%). The associations between default rate and demographic variables like age and gender were found statistically significant. CONCLUSION: Default rate among COPDpatients is significantly associated with GOLD Group A and D, patient's income and patient literacy level. Main reasons for default were non-affordability of treatment expenses, too ill to come and resolution of symptoms.
Authors: Ramsey Sabit; Timothy L Griffiths; Alan J Watkins; Wendy Evans; Charlotte E Bolton; Dennis J Shale; Keir E Lewis Journal: Respir Med Date: 2008-03-11 Impact factor: 3.415
Authors: Maarten J Fischer; Margreet Scharloo; Jannie J Abbink; Alex J van 't Hul; Dirk van Ranst; Arjan Rudolphus; John Weinman; Klaus F Rabe; Adrian A Kaptein Journal: Respir Med Date: 2009-05-29 Impact factor: 3.415