DIFFERENTIATED APPROACH TO THE APPOINTMENT OF BRONCHODILATOR THERAPY IN PATIENTS WITH COPD. EXAMPLES FROM PRACTICE

Abstract

The article deals with the issues of differentiated approach to the appointment of bronchodilator therapy in COPD patients on the basis of a comprehensive assessment of the SGRQ quality of life questionnaire, CAT questionnaire, BODE prognostic index, and clinical and functional indicators (FEV1 and MRC index). Clinical examples of patient management are presented. The aim of the study was to study new approaches to the differentiated use of bronchodilator therapy. Material and methods: The study included 49 male patients treated in Regional Clinical Hospital No. 4 and the Pulmonary Center in Chelyabinsk in 2016-17. The analysis of drug therapy in all patients was conducted. The quality of life (QoL) was assessed using two questionnaires: the Russian-language version of the St. George Hospital (SGRQ) questionnaire, and the CAT universal questionnaire. The prognostic evaluation index BODE is calculated. Results and conclusions: 1. Combined preparation of glycopyrronium bromide / indacaterol 50/110 mcg is an effective and safe means for conducting bronchodilator therapy in patients with different variants of the course of COPD. 2. When double bronchodilator therapy is used, the increase in FEV1 by more than 60 ml is observed, especially in patients with a high risk of exacerbations and marked symptoms of the disease. 3. Application of quality of life questionnaires allows to be guided by correctness of the chosen medical tactics both in early, and in the remote periods of supervision of patients with COPD. 4. The use of prognostic indices in the selection of treatment tactics allows to evaluate the correctness of prescriptions at the early stages of patient management.