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Étude préliminaire au déploiement d'un parcours de soins coordonnés pour les patients atteints de BPCO au sein d'une maison de santé pluriprofessionnelle
Mémoire de Master / Thèse d'exercice

Étude préliminaire au déploiement d'un parcours de soins coordonnés pour les patients atteints de BPCO au sein d'une maison de santé pluriprofessionnelle

Louis-Marie Durel
Masters , Université de Montpellier
08/06/2021

Résumé

COPD Care pathway Multiprofessional health center Bronchodilator BPCO Parcours de soins HAS Maison de santé Médecins généralistes Tabac Bronchodilatateurs Vaccination General practitioners Tobacco
Background: COPD (Chronic Obstructive Pulmonary Disease) is about to become the third leading cause of death by 2030. In 2020, the French National Authority for Health (HAS) published for healthcare professionals a care pathway guide on the management of COPD patients. Following a call for projects from the Regional Health Agency in 2018, the multiprofessional health center (MSPU) of Cabestany proposed a "COPD care protocol". This study is a preliminary step to the implementation of this project.Objectives: to describe the management of COPD patients within a MSPU. To measure the prevalence of patients at risk of COPD and to compare the management by general practitioners.Methods: single-center, retrospective, descriptive study of COPD patients from initial assessment to treatment.Results: 88 patients were included in the study (mean age ± SD: 69 ± 9,97 years), mainly men. 75% of the patients were at stage I or II. The median number of comorbidities was 3. No occupational diseases were reported. Complete smoking cessation was achieved in 60% of patients. 30% of patients were treated with triple therapy and more than half were taking inhaled corticosteroids. Only 1/3 of patients had received a pneumococcal vaccination. No assessment of dyspnoea or number of exacerbations was noted in the medical records. More than 1/3 of patients have had an exacerbation during the year, with a significant predominance in women. 868 patients were at risk of COPD, 11.4% of whom had already had spirometry. There was no significant difference in management between physicians.Conclusion: this study allowed to take a step back and to identify the differences between the HAS recommendations and the current management practices of COPD patients in an MPSU. The implementation of a care protocol taking into account these results could make it possible to fill in the gaps and to compare the situation several months later.

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