PATIENT CHARACTERISTICS AND SHORT-TERM EFFECTIVENESS OF SHORT-ACTING BRONCHODILATOR COMBINATION OF SALBUTAMOL/IPRATROPIUM IN PATIENTS WITH CHRONIC OBSTRUCTION PULMONARY DISEASE (COPD): A CROSS-SECTIONAL MULTICENTER STUDY IN VIET NAM

Tóm tắt

Background and objectives: Chronic obstructive pulmonary disease (COPD) is a common disease. There have been no studies evaluating patient characteristics, management and treatment status and short-term effectiveness of the short-acting bronchodilator combination of salbutamol/ipratropium in patients being managed by a respiratory facilities in Vietnam. This is the reason for this study. Patients and methods: Prospective, descriptive, cross-sectional, multicenter study design. Patients are those who have been diagnosed with COPD (determined by FEV₁/FVC value <70%) and are being managed and treated at 5 medical facilities with representative respiratory operations across the country. Convenient, random, consecutive sampling of cases being managed and guided for treatment at participating facilities over a period of 30 days. All patients in the study were asked about treatment history and exacerbations in the previous 12 months, and assessed the level of current dyspnea compared to the best condition the patient had using the VAS scale ( visual analogue scale) and performed chest X-ray, measured lung function by spirometry before and after nebulizing a dose of the short-acting bronchodilator of salbutamol/ipratropium combination. Data were recorded on a unified data collection sheet. Results and discussion: There were 183 patients in the study. The rate of using LABDs is 98.4%, ICS is 58.5%. The number of patients with frequent exacerbations is 74 (40.40%). The number of patients with at least 1 severe exacerbation hospitalized is: 60 (32.78%). The number of patients who used medication (including at least one of short-acting bronchodilators, long-acting bronchodilators, and corticosteroids) within 4 hours before examination was: 176 (96.17%). The average VAS score before medication was 4.26. The proportion of chest X-rays containing old tuberculosis lesions is 26 (14.20%). There is a significant correlation between VAS scores before, after medication and FEV₁ values before, after medication and the change is ≥12% compared to predicted value. There is a high rate, 46.15% of patients with old tuberculosis lesions being treated with ICS. High rate of BMI <19 kg/m² (27.30%). There is a positive correlation between BMI and %FEV₁ pred. value, underweight (BMI <19kg/m²) was significantly associated with reduced %FEV₁ pred. before medication (p<0.001). Conclusion: On 183 patients being managed and treated, it shows that there are characteristics that need to be paid attention to in terms of drug use indications, treatment effectiveness and physical characteristics expressed through BMI. With the above characteristics of symptoms, respiratory function and exacerbation, it shows that individualized management and treatment is not required to reduce symptoms. This shows that it is very necessary to add short-acting bronchodilators to treatment. The VAS scale, an intuitive, easy-to-use assessment tool that has a significant correlation with the FEV₁ value, can be helpful for quickly assessing the patient's symptom control status in daily practice.