Rf8.4 Copd Exacerbation: The Results Of A Collaboration Between Hospital, Gp's And Local Health Unit

Author(s): 
S. Chirchiglia1, P. Nigro1, P. Longoni2, I. Pangrazzi1, A. Premoli1
1 Distretto, ASL Città di Milano, Italy
2 Medico di Medicina Generale, Italy
Text: 
Introduction.
Chronic Obstructive Pulmonary Disease (COPD) is currently estimated to be the 5th cause of death worldwide. The diagnostic and therapeutic approaches to this pathology are deficient and social determinants underestimated. These data, along with the lack of hospital-community based protocol for COPD have stimulated a collaborative project between general practitioners (GPs), hospital based pneumologists (Sacco and Niguarda) and the Local Health Unit.
Objective.
To compare the professional behaviour of GPs and pneumologists with respect to patients with COPD exacerbation and to develop tools for an integrated hospital-community practice.
Methods and Results.
During a one-year observation period, a group of 62 GPs and 4 pneumologists have documented 402 cases of COPD exacerbations. Of these, 349 (85%) were sent by the GPs and 63 (15%) by the specialists. The majority of patients were male (57.5%), 2 cases were less than 40 years old, 62 were aged between 41 and 60, 281 between 61 and 80, and 63 were older than 80.
Conclusions.
The main differences between GPs and pneumologists seem to concern the more clinical severity of cases observed in hospital, the more frequently use of respiratory function and prescription of the different antibiotic drugs by specialists. The study shows the feasibility of research protocol in collaboration between hospital, GPs and Local Health Unit.
Literature: 
RF8.4 COPD EXACERBATION: THE RESULTS OF A COLLABORATION BETWEEN HOSPITAL, GP's AND LOCAL HEALTH UNIT