Primary care physician perceptions on the diagnosis and management of chronic obstructive pulmonary disease in diverse regions of the world

Chronic obstructive pulmonary disease (COPD) is a multicomponent disorder that leads to substantial disability, impaired quality of life, and increased mortality. Although the majority of COPD patients are first diagnosed and treated in primary care practices, there is comparatively little information on the management of COPD patients in primary care. A web-based pilot survey was conducted to evaluate the primary care physician's, or general practitioner's (GP's), knowledge, understanding, and management of COPD in twelve territories across the Asia-Pacific region, Africa, eastern Europe, and Latin America, using a 10-minute questionnaire comprising 20 questions and translated into the native language of each participating territory. the questionnaire was administered to a total of 600 GPs (50 from each territory) involved in the management of COPD patients and all data were collated and analyzed by an independent health care research consultant. This survey demonstrated that the GPs' understanding of COPD was variable across the territories, with large numbers of GPs having very limited knowledge of COPD and its management. A consistent finding across all territories was the underutilization of spirometry (median 26%; range 10%-48%) and reliance on X-rays (median 14%; range 5%-22%) for COPD diagnosis, whereas overuse of blood tests (unspecified) was particularly high in Russia and South Africa. Similarly, there was considerable underrecognition of the importance of exacerbation history as an important factor of COPD and its initial management in most territories (median 4%; range 0%-22%). Management of COPD was well below guideline-recommended levels in most of the regions investigated. the findings of this survey suggest there is a need for more ongoing education and information, specifically directed towards GPs outside of Europe and North America, and that global COPD guidelines appear to have limited reach and application in most of the areas studied.GlaxoSmithKlinePulmonol Res Inst, Moscow, RussiaFudan Univ, Dept Pulm Med, Shanghai 200433, Peoples R ChinaCtr Med Amer, Merida, Yucatan, MexicoHosp Rehabil Resp Maria Ferrer, Buenos Aires, DF, ArgentinaCharlotte Maxeke Johannesburg Hosp, Dept Internal Med, Johannesburg, South AfricaUniv Witwatersrand, Fac Hlth Sci, Johannesburg, South AfricaNihon Univ, Sch Med, Dept Internal Med, Div Resp Med, Tokyo, JapanUniversidade Federal de São Paulo, São Paulo, BrazilChinese Univ Hong Kong, Dept Med & Therapeut, Hong Kong, Hong Kong, Peoples R ChinaUniv Autonoma Baja California, Fac Med, Tijuana, Baja California, MexicoGlaxoSmithKline, Med Affairs, Brentford TW8 9GS, EnglandEge Univ, Sch Med, Dept Chest Dis, Izmir, TurkeyKorea Univ, Med Ctr, Dept Pulmonol, Guro Hosp, Seoul, South KoreaChang Gung Mem Hosp, Dept Resp Care Med, Chiayi, TaiwanUniv Western Australia, Sch Med & Pharmacol, Perth, WA 6009, AustraliaUniversidade Federal de São Paulo, São Paulo, BrazilWeb of Scienc