Based on the increasing incidence of chronic obstructive pulmonary disease (COPD), it is necessary to analyze the problems in providing pulmonary care to the population of the Russian Federation.
OBJECTIVE
To study the problems of providing pulmonary care to patients with COPD according to the results of a medical and sociological study and to determine the priority directions for its improvement.
MATERIALS AND METHODS
A survey of 338 patients living in 22 regions of the Russian Federation with a history of COPD was conducted.
RESULTS
The study showed that 29.8% of COPD patients were not under regular medical check-ups by a primary care physician or pulmonologist; 36.6% were under regular medical check-ups by a pulmonologist and 33.6% by a primary care physician. Patients managed by a pulmonologist receive better medical care than those managed by primary care physicians, regardless of the region of residence in Russia. It is because primary care physicians are less likely to implement preventive, diagnostic, and rehabilitation measures for COPD patients than pulmonologists. In particular, primary care physicians are twice less likely to prescribe subsidized drugs compared to pulmonologists (22.8% vs. 40.3%). Among the respondents, 72% have a disability due to COPD, of which 52.2% have the group I, 5.9% group II, and 13.9% group III. COPD patients with group I disability have a higher annual rate of hospitalizations (1.45±0.83) and a lower annual rate of visits to a pulmonologist (0.97±0.26) compared to other patients. Also, 40.1% of COPD patients need subsidized drugs.
CONCLUSION
The main directions of improving pulmonary care for patients with chronic obstructive pulmonary diseases are: to improve its quality and accessibility for low-mobility patients at home, optimize routing, adhere to clinical guidelines and the standard of care, improve subsidized drug provision, and implement targeted federal and regional programs to reduce COPD-related morbidity and mortality. All these measures combined will reduce COPD incidence and the economic burden, improve the quality of life of patients with chronic obstructive pulmonary disease, and increase their life expectancy.