489 Role Of Factors Influencing Family Physician Adherence To Chronic Obstructive Pulmonary Disease Treatment Guideline Recommendations

Oleksii Korzh - Kharkov Medical Academy of Postgraduate Education
S. Krasnokutskiy - Kharkov Medical Academy of Postgraduate Education
G. Kotchuev - Kharkov Medical Academy of Postgraduate Education
Family physicians do not prescribe medication for the treatment of chronic obstructive pulmonary disease (COPD) according to current guidelines. This study investigates possible reasons for this. Aims: The objectives were to measure the knowledge, attitude and stated practice of family physicians to the initiation of pharmacotherapy for uncomplicated COPD and to explore the reasons why clinical practice differs from guideline recommendations.
Design & Methods: A cross-sectional postal survey conducted between April and November 2006 in the Kharkov region, Ukraine. A three-phase postal survey was undertaken of a random sample of family physicians. The survey instrument included respondent characteristics, preference for initiation of drug therapy for COPD and their opinion of efficacy, adverse effects and long-term safety, as well as knowledge of guidelines.
Results: Ranked preference of drugs for uncomplicated COPD, opinion of drug efficacy, adverse effects and safety. Older agents are preferred to newer agents in the initiation of drug therapy contrary to current guideline recommendations. Newer agents were not thought to be more efficacious, have better short- and long-term adverse effect profiles and be more expensive than older agents. Older doctors most often held these attitudes. Guidelines influenced decision making but were not the most important factor.
Conclusions: There is a demonstrable need for governments to invest in the promotion of accurate information on drugs through continuing education and facilitating the production of standardized paper and web-based clinical guidelines. A program of targeted investment in clinical trials that examine the justification for different classes of agents should also be considered.
Role of factors influencing family physician adherence to chronic obstructive pulmonary disease treatment guideline recommendations