Evaluation of professional practice in the management of COPD at Montpellier University Hospital

Introduction. - Chronic obstructive pulmonary disease (COPD), because of its severity and prevalence, is an important target for the evaluation of professional practices. We present the results of an evaluation at Montpellier University Hospital in 2006 (number of admissions 4800/yr). Results. - One hundred and twenty-one observations were retrieved, 8% of the total where COPD was recorded as the principal diagnosis (Median age: 66 years; male: 67%). Eighty-eight per cent of the patients had undergone thoracic radiography and 50.8% had had lung function testing. Body mass index was recorded for 89.9% of the patients and the annual number of exacerbations in 14.9%. Information on smoking cessation was given to only 41.9% of the patients, pulmonary rehabilitation was considered in 14.5% and bronchodilators and/or inhaled corticoids were prescribed for 47.8%. Patients admitted under the care of a respiratory team were significantly more likely to have received information on the means of smoking cessation: 75% vs. 35% (p: 0.0004), lung function testing: 73% vs. 38% (p: 0.0005) and been offered pulmonary rehabilitaion: 35% vs. 5% (p < 0.0001). Conclusion. - There is considerable room for improvement in the care of COPD within the hospital in order for it to conform to national and international guidelines. Specialist respiratory care is more adherent with guidelines than non-specialist care. (C) 2010 SPLF. Published by Elsevier Masson SAS. All rights reserved.