Résumé
Introduction. Recommendations for the management of patients with obstructive lung diseases have been published. They are based on randomized controlled trials conducted in populations of patients selected on the basis of numerous criteria. The aim of this study was to assess the proportion of outpatients consulting for an obstructive lung disease, asthma or chronic obstructive pulmonary disease (COPD) who met the inclusion criteria of the randomized controlled trials taken in account for the recommendations. The hypothesis was that the patients selected in these clinical trials represent only a minority of the patients actually affected in real life.
Method. All adult patients with an obstructive lung disease seen consecutively in consultation by 3 pneumologists and 9 general practitioners were included during 6 months. The criteria for inclusion in the clinical trials which form the basis for the recommendations were applied to the these patients.
Results. 870 patients were included. 334 patients suffered from asthma, 366 from COPD and 170 from an intermediate type of obstructive lung disease. After applying the selection criteria, only 3.3% of asthmatic patients and 17.2% of the patients with COPD would have been included in the clinical trials used to draw up the recommendations.
Conclusion. This study has shown that the clinical trials that formed the basis of the management recommendations represented only a small percentage of the population of patients consulting on a normal daily basis general practitioners and hospital-based pneumologists. It is therefore reasonable to wonder if the recommendations are relevant in "real life".