Adherence of North-African Pulmonologists to the 2017-Global Initiative for Chronic Obstructive Lung Disease (GOLD)‎ Pharmacological Treatment Guidelines (PTGs)‎ of Stable Chronic Obstructive Pulmonary Disease (COPD)‎

Abstract EN

Background.

No previous study has investigated the adherence rate of North-African pulmonologists to the 2017-GOLD PTGs.

Aims.

To investigate the adherence rate of Tunisian pulmonologists to the 2017-GOLD PTGs and to identify the barriers to their adherence.

Methods.

This was a cohort study involving clinically stable COPD patients who presented to a pulmonology outpatient consultation.

The patients were classified as having been appropriately and inappropriately (over- or undertreatment) treated for the GOLD group.

Logistic regression was performed to determine the adherence barriers to the 2017-GOLD PTGs.

Results.

A total of 296 patients were included (88.1% males, mean age: 68±10 years; GOLD A (7.1%), B (36.1%), C (4.1%), and D (52.7%)).

The pulmonologists’ adherence rate to the 2017-GOLD PTGs was 29.7%.

There was a significant statistical difference between the adherence rates among the four GOLD groups (A: 19.0%, B: 20.6%, C: 8.3%, and D: 39.1%; p=0.001).

Differences were statistically significant between the GOLD group D and groups B (p=0.001) and C (p=0.033).

The multivariate analysis showed that age (odds ratio (OR): 0.968), socioeconomic level (high/medium vs.

low; OR: 2.950), insurance type (national health insurance vs.

others; OR: 2.851), and GOLD groups (A/B vs.

C/D; OR: 3.009) significantly influenced the adherence rate to the 2017-GOLD PTGs.

Conclusion.

The adherence rate of Tunisian pulmonologists to the 2017-GOLD PTGs is low.

It seems that the patients’ age, socioeconomic level, national health insurance coverage, and GOLD groups influenced their adherence.