| Objective: To investigate the knowledge and clinical practice of"Guideline for management of COPD"among the physicians in local hospitals of Chongqing, identify the differences between clinical practice and guideline, analyze the reasons for the differences, then discuss measures to promote the implementation of this guideline. And to improve the level of diagnosis and treatment of COPD.Methods: Questionnaire was designed and used to investigate the knowledge and clinical practice of"Guideline for management of COPD"among physicians working in general medicine or respiratory medicine.5 municipal hospitals,10 county level hospitals and 20 township-level hospitals were selected randomly. Questionnaires were sent to the physicians, the physicians filled out the questionnaires and returned them back. The data obtained by the questionnaire was analyzed by SPSS17.0 software.Results:A total of 216 effective questionnaires were collected. The physicians who read or were familiar with the guidelines were 37.0% and 6.5% respectively.39.4% physicians were acquainted with the lung function criteria for diagnostic of COPD, with the number of municipal hospitals significantly higher than the county level and township-level hospitals (P = 0.012).Among those,20% suggested patients to do lung function tests. With pharmacotherapy of stable COPD, 29.2% suggested long-term inhalation of corticosteroids with long-acting beta-agonists, with the number of municipal hospitals higher than country level hospitals (P <0.01); 12.5% recommend inhalation of single corticosteroids, between municipal hospitals and country level hospitals there was no a significant difference(P>0.05); 83.3% proposed inhalation short-acting bronchodilators on-demand, with the number of municipal hospitals, country level hospitals higher than the township level hospitals(P<0.05). 41.7% proposed long-term administration of oral corticosteroids, with the number of municipal hospitals, country level hospitals lower than the township level hospitals(P<0.05);68.1% proposed long-term administration of antibiotics, with the number of municipal hospitals higher than country level hospitals and township level hospitals(P<0.05).52.3% knew oxygen therapy indications. 88.4% recommended patients with Long-term domiciliary oxygen therapy and 62.5% knew oxygen therapy time that is more than 15h, with the number of municipal hospitals higher than township-level hospitals(P<0.05). 46.8% proposed patients to do rehabilitation, no significant difference was found among physicians in hospitals with different grade(P>0.05). As regards to AECOPD, 69.0% suggested to do pathogenic examination in acute exacerbation, with the number of municipal and county level hospitals higher than township-level hospitals(P <0.01),the percentage of physicians who choose the initial antibiotic treatment by overall analysis, selection based personal clinical experience or random selection were 2.3% ,44.4%, 0.9% respectively; 70.7% physicians chose bronchodilator combination therapy and 49.3% preferred inhalation therapy. The administration of glucocorticoid was mostly in accordance with COPD guideline recommendation.Conclusion: The physicians in chongqing were lack of knowledge of guideline for management of COPD; The percentage of physicians who knew lung function criteria of COPD were at low rate; Stability of drug treatment for stable COPD was not standardized, the rate of using long-term inhalation of corticosteroids with long-acting beta-agonists or inhalation of single corticosteroids was low ,the rate of using oral corticosteroids or antibiotics was high; The physicians were lack of knowledge about Long-term domiciliary oxygen therapy, a few physicians proposed to do rehabilitation; For acute exacerbation of COPD ,the rate of pathogenic examination was low, initial antibiotic using was not standardized. To enhance the education of physicians and promote treatment based on guideline are the keys in clinical prevention and treatment of COPD.
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