Effects Of Short-term Education And Spirometry On The Ability Of Physicians To Diagnose And Treat COPD

Objectives:To measure the effects of short-term education about COPD on the physicians’knowledge relating to Chronic Obstructive Pulmonary Disease (COPD) and short term education about COPD combined with access to spirometry on the ability of physicians to diagnose and treat COPD.Methods:Eight2nd level hospitals without spirometry in Hunan province were sampled randomly in the first intervention, physicians in ambulatory clinics and inpatient department willing to participate in the study were screened in those hospitals. A short-term education lecture based on the Chinese COPD Guidelines was held. The questionnaires surveying the contents of the guideline were administered to the physicians before and after the short-term COPD education. The mean scores of the questionnaires and the correct rates of each question before and after the lecture are compared. In Second intervention, four2nd level hospitals received spirometry equipment for one month immediately after the lecture. Patients meeting inclusion/exclusion criteria were recruited in ambulatory clinics by the researchers. Spirometry was performed for the subjects by a researcher before they visited the physicians. Berfore and after the physicians read the spirometry results, they were queried as to whether the subjects had COPD diagnosis and if so, they were asked to quantify severity and whether a prescription needed for COPD. Physicians’responses before and after they read spirometry results were compared.Results:For the first intervention,207physicians participated in the short-term COPD education lecture and finished the questionnaires. The mean scores of the questionnaires before and after the lecture are53.14±21.73,93.33±9.75respectively (P0.0001); the correct rates of ten questions in testing questionnaire about COPD before and after the lecture are compared by the chi-square test (all P<0.0001). For the second intervention,18physicians and307subjects participated in this study. Prevalence of COPD among the307subjects is38.76%(119/307). Before and after the physicians read the spirometry results, percentage of correct diagnosis for307subjects is76.55%(235/307) versus97.39%(299/307) respectively (P＜0.0001), percentage of missed diagnosis for119COPD subjects is28.57%(34/119) versus1.68%(2/119) respectively (P<0.0001), percentage of misdiagnosis for188subjects without COPD is20.21%(38/188) versus3.19%(6/188) respectively (P＜0.0001), percentage of grading the severity of COPD correctly is25.21%(30/119) versus87.39%(104/119) respectively (P＜0.0001), percentage of underestimating the severity of COPD is40.34%(48/119) versus6.72%(8/119) respectively (P＜0.0001), percentage of prescribing medication for COPD subjects is18.49%(22/119) versus84.03%(100/119) respectively (P＜0.0001).Conclusions:Short-term education about COPD can improve the physicians’knowledge relating to COPD. Spirometry combined with Short-term education about COPD can improve the ability of physicians to diagnose COPD and physicians’accuracy in the assessment of COPD severity. Accurate diagnosis of grading COPD severity can improve the ability of physician to make a correct prescription for COPD treatment.