Management of acute COPD exacerbations in France: A qualitative survey in a private practice setting

PLoS One. 2021 Jan 22;16(1):e0245373. doi: 10.1371/journal.pone.0245373. eCollection 2021.

Abstract

Background: The current prevalence of chronic obstructive pulmonary disease (COPD) in France is estimated to be 2.6 million and is predicted to increase to 2.8 million by 2025. Presently, there is a lack of data on COPD management within the private healthcare setting. The aim of this study was to investigate the management of COPD exacerbations by pulmonologists within private practices in France.

Methods: A prospective, online, qualitative survey was distributed to private practice pulmonologists in France. The survey covered all aspects of COPD management from diagnosis and therapeutic management, to secondary prevention and organization of care. Survey responses were collected between 27 January 2018 and 18 June 2018 and all data were summarized descriptively.

Results: The survey had a response rate of 20.6%, with 116 out of 563 pulmonologists providing responses. Overall, 87.4% of respondents stated that the management of COPD represented over 15% of their total clinical activity. Most respondents indicated that they work closely with general practitioners and a large multidisciplinary team to manage patients with numerous comorbidities. Following a COPD exacerbation, the majority of respondents (78.4%) were in favor of using respiratory-connected devices (class 2a-connected medical device according to the French HAS classification and available on medical prescription) to assist with patient follow-up at home.

Conclusions: COPD management forms part of the core clinical activity for pulmonologists within the private practice setting in France. Patients with COPD generally have multiple comorbidities and are managed by a multidisciplinary team in line with French guidelines. The use of respiratory-connected devices was highlighted as an important new strategy for improving patient care following a COPD exacerbation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Disease Management
  • France / epidemiology
  • Humans
  • Middle Aged
  • Practice Patterns, Physicians'
  • Private Practice
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / epidemiology
  • Pulmonary Disease, Chronic Obstructive / prevention & control
  • Pulmonary Disease, Chronic Obstructive / therapy*
  • Qualitative Research
  • Secondary Prevention

Grants and funding

This survey was funded by GlaxoSmithKline, who had a role in the design of the survey, data analysis, data interpretation, and writing of the report. GlaxoSmithKline also provided support in the form of salaries for AC and ZA. The specific roles of these authors are articulated in the ‘author contributions’ section. Editorial support (in the form of writing assistance, assembling figures, collating author comments, grammatical editing and referencing) was provided by Katie Baker, PhD, at Fishawack Indicia Ltd, UK, and was funded by GlaxoSmithKline.