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Pharmacotherapy of chronic obstructive pulmonary disease: Assessment of knowledge of doctors and senior students. Results of the ASCO III study

https://doi.org/10.21518/ms2025-506

Abstract

Introduction. Chronic obstructive pulmonary disease (COPD) is one of the leading causes of mortality worldwide. The global prevalence of COPD is estimated at 10.3%. In Russia, there are more than 4 million patients with COPD, with 40% requiring hospitalization and 14% needing rehospitalization. Such statistics highlight the significance of COPD.

Aim. To assess the level of knowledge among physicians and senior medical students regarding COPD pharmacotherapy.

Materials and methods. This article presents an analysis of data on the knowledge assessment and preferences of specialists and senior medical students regarding COPD pharmacotherapy, obtained during the multicenter ASCO III study conducted between 2019 and 2023.

Results. A total of 420 physician questionnaires from 11 regions and 372 student questionnaires from 7 medical universities were analyzed. The average level of correct answers (LCA) was 56.1% among physicians and 41.6% among students (p < 0.001). Respondents demonstrated the best results in questions related to the combination of drugs in a single delivery device. The poorest results were observed in questions regarding the choice of baseline therapy for severe COPD symptoms and the optimal selection of antibacterial agents during disease exacerbations. Correlation analysis of the relationship between “LCA” and “Years of Experience” among physicians revealed a weak inverse correlation between specialists’ knowledge level and their work experience.

Conclusions. A relatively low level of knowledge in COPD pharmacotherapy was identified among both physicians and students. Physicians demonstrated significantly better knowledge than students in most areas. According to the authors, there is a need for continued assessment of knowledge in real-world practice and the optimization of both core and supplementary educational activities in this field.

About the Authors

R. A. Bontsevich
Mari State University; Belgorod State National Research University; Kazan State Medical Academy – branch of the Russian Medical Academy of Continuing Professional Education; Pushchino Branch of the Russian Biotechnology University (BIOTECH University)
Russian Federation

Roman A. Bontsevich, Cand. Sci. (Med.), Associate Professor, Associate Professor of the Department of Internal Diseases No. 2, Director of the Medical Scientific and Educational Center, Mari State University; Associate Professor of the Department of Pharmacology and Clinical Pharmacology, Belgorod State National Research University;  Associate Professor of the Department of Clinical Pharmacology and Pharmacotherapy, Kazan State Medical Academy – branch of the Russian Medical Academy of Continuing Professional Education; Associate Professor, Pushchino Branch of the Russian Biotechnology University (BIOTECH University)

1, Lenin Square, Yoshkar-Ola, 424000; 
85, Pobedy St., Belgorod, 308015; 
36, Butlerov St., Kazan, 420012; 
3, Nauki Ave., Pushchino, Moscow Region, 142290


G. I. Zavitkevich
Mari State University
Russian Federation

Georgy I. Zavitkevich, Student of the Medical Institute, Research intern of the Medical Scientific and Educational Center

1, Lenin Square, Yoshkar-Ola, 424000


G. A. Batishcheva
Voronezh State Medical University named after N.N. Burdenko
Russian Federation

Galina A. Batishcheva, Dr. Sci. (Med.), Professor, Head of Department of Clinical Pharmacology, Voronezh State Medical University named after N.N. Burdenko

10, Studencheskaya St., Voronezh, 394036


V. A. Nevzorova
Pacific State Medical University
Russian Federation

Vera A. Nevzorova, Dr. Sci. (Med.), Professor, Head of the Institute of Therapy and Instrumental Diagnostic

2, Ostriakov Ave., Vladivostok, 690002


O. V. Tsygankova
Novosibirsk State Medical University; Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences
Russian Federation

Oksana V. Tsygankova, Dr. Sci. (Med.), Professor, Professor of the Department of Emergency Medicine with Endocrinology and Occupational Pathology of the Faculty of Continuing Education and Professional Retraining of Doctors, Novosibirsk State Medical University; Senior Researcher, Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences

52, Krasny Ave., Novosibirsk, 630091; 
175/1, B. Bogatkov St., Novosibirsk, 630089


G. S. Rozanova
Mari State University; Pushchino Branch of the Russian Biotechnology University (BIOTECH University)
Russian Federation

Galina S. Rozanova, Postgraduate Student of the Department of Pharmacology and Clinical Pharmacology, Pushchino Branch of the Russian Biotechnology University (BIOTECH University);  Specialist of the Medical Scientific and Educational Center, , Mari State University

1, Lenin Square, Yoshkar-Ola, 424000; 
3, Nauki Ave., Pushchino, Moscow Region, 142290


G. G. Ketova
South Ural State Medical University
Russian Federation

Galina G. Ketova, Dr. Sci. (Med.), Professor, Professor of the Department of Outpatient Therapy and Clinical Pharmacology, South Ural State Medical University

64, Vorovskiy St., Chelyabinsk, 454092


I. M. Martynenko
Pacific State Medical University
Russian Federation

Irina M. Martynenko, Cand. Sci. (Med.), Associate Professor, Institute of Therapy and Instrumental Diagnostics

2, Ostriakov Ave., Vladivostok, 690002


I. F. Krotkova
Russian Medical Academy of Continuous Professional Education
Russian Federation

Irina F. Krotkova, Cand. Sci. (Med.), Associated Professor of the Department of therapy

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993


E. Yu. Ebzeeva
Russian Medical Academy of Continuous Professional Education
Russian Federation

Elizaveta Yu. Ebzeeva, Cand. Sci. (Med.), Associated Professor of the Department of therapy 

2/1, Bldg. 1, Barrikadnaya St., Moscow, 125993


G. M. Bikkinina
Bashkir State Medical University
Russian Federation

Guzel M. Bikkinina, Dr. Sci. (Med.), Professor, The Department of Pharmacology

3, Lenin St., Ufa, 450000


E. A. Shabanov
Kursk State Medical University
Russian Federation

Evgeniy A. Shabanov, Cand. Sci. (Med.), Associated Professor of the Department of Internal Medicine Faculty of Postgraduate Education

3, Karl Marks St., Kursk, 305004


G. G. Prozorova
Voronezh State Medical University named after N.N. Burdenko
Russian Federation

Galina G. Prozorova, Dr. Sci. (Med.), Professor of the Department of Therapeutic Disciplines of the Institute of Additional Education

10, Studencheskaya St., Voronezh, 394036


U. M. Tilekeeva
Kyrgyz State Medical Academy
Kyrgyzstan

Ulankul M. Tilekeeva, Dr. Sci. (Med.), Professor Head of the Department of Basic and Clinical Pharmacology

92, Akhunbaev St., Bishkek, 720020, Kyrgyz Rebublic


O. G. Kompaniets
Kuban State Medical University
Russian Federation

Olga G. Kompaniets, Cand. Sci. (Med.), Chief Clinical Pharmacologist of Krasnodar City, Associated Professor of the Department of Therapy No. 1

4, Sedin St., Krasnodar, 350063


E. N. Bochanova
Krasnoyarsk State Medical University named after Professor V.F. Voino-Yasenetsky
Russian Federation

Elena N. Bochanova, Dr. Sci. (Med.), Associated Professor Head of the Department of Microbiology named after Associate Professor B.M. Zelmanovich

1, Partizan Zheleznyak St., Krasnoyarsk, 660022


E. V. Luchinina
Saratov State Medical University named after V.I. Razumovsky
Russian Federation

Elena V. Luchinina, Cand. Sci. (Med.), Associated Professor of the Department of Occupational Pathology, Hematology and Clinical Pharmacology

112, Bolshaya Kazachia St., Saratov, 410012


S. Yo. Yormamadov
Mari State University
Russian Federation

Samson Yo. Yormamadov, Student of the Medical Institute

1, Lenin Square, Yoshkar-Ola, 424000


P. Hasanzoda
Mari State University
Russian Federation

Parviz Hasanzoda, Student of the Medical Institute

1, Lenin Square, Yoshkar-Ola, 424000


M. L. Maximov
Kazan State Medical Academy – branch of the Russian Medical Academy of Continuing Professional Education; Pirogov Russian National Research Medical University; Russian Medical Academy of Continuous Professional Education
Russian Federation

Maxim L. Maximov, Dr. Sci. (Med.), Professor, Head of the Department of Clinical Pharmacology and Pharmacotherapy, Kazan State Medical Academy – branch of the Russian Medical Academy of Continuing Professional Education; Professor of the Department of Pharmacology of the Institute of Pharmacy and Medical Chemistry, Pirogov Russian National Research Medical University; Head of the Department of Pharmacy, General Pharmacology, and Pharmaceutical Counseling, Dean of the Faculty of Preventive Medicine and Health Care Organization, Russian Medical Academy of Continuous Professional Education

36, Butlerov St., Kazan, 420012;
1, Ostrovityanov St., Moscow, 117997;
2/1, Bldg. 1, Barrikadnaya St., Moscow, 125


References

1. Venkatesan P. GOLD COPD report: 2025 update. Lancet Respir Med. 2025;13(1):e7–e8. https://doi.org/10.1016/S2213-2600(24)00413-2.

2. Buist AS, Vollmer WM, Sullivan SD, Weiss KB, Lee TA, Menezes AM et al. The Burden of Obstructive Lung Disease Initiative (BOLD): rationale and design. COPD. 2005;2(2):277–283. Available at: https://pubmed.ncbi.nlm.nih.gov/17136954.

3. Maliavin AG, Dzanaeva AV, Avxentyeva MV, Babak SL. Medical and economic analysis of the consequences of expanding the drug supply program for patients with chronic obstructive pulmonary disease in the Russian Federation. Medical Technologies. Assessment and Choice. 2019;(3):53–61. (In Russ.) Available at: https://www.elibrary.ru/ujzdtj.

4. Bontsevich RA, Shchurovskaya KV, Pokrovskaya TG, Goncharova NYu, Batisheva GA, Barysheva VO et al. Estimation of basic knowledge of COPD issues in graduate students – final results of ASCO study. Farmateka. 2018;(8):72–78. (In Russ.) https://doi.org/10.18565/pharmateca.2018.8.72-78.

5. Bontsevich RA, Shershneva AS, Vovk YR, Filinichenko TS, Prozorova GG, Kirichenko AA et al. Chronic obstructive pulmonary disease: assessment of the knowledge of therapeutic doctors. The results of the ASCO-II study. Vrach. 2020;31(7):68–74. (In Russ.) https://doi.org/10.29296/25877305-2020-07-13.

6. Bontsevich RA, Adonina AV, Vovk YR, Batisheva GA, Cherenkova OV, Ketova GG et al. Management of Chronic Obstructive Pulmonary Disease. Arch Razi Inst. 2022;77(1):439–447. https://doi.org/10.22092/ari.2021.356613.1882.

7. Чучалин АГ, Авдеев СН, Айсанов ЗР, Белевский АС, Лещенко ИВ, Овчаренко СИ и др. Хроническая обструктивная болезнь легких: клинические рекомендации. 2018. Режим доступа: https://cr.minzdrav.gov.ru/archive.

8. Singh D, Agusti A, Anzueto A, Barnes PJ, Bourbeau J, Celli BR et al. Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Lung Disease: the GOLD science committee report 2019. Eur Respir J. 2019;53(5):1900164. https://doi.org/10.1183/13993003.00164-2019.

9. Bontsevich RA, Zavitkevich GI, Batishcheva GA, Nevzorova VA, Tsygankova OV, Ketova GG et al. Etiology, pathogenesis and diagnosis of chronic obstructive pulmonary disease: Assessment of the knowledge of doctors and senior students. Results of the ASCO-III study. Meditsinskiy Sovet. 2025;19(9):69–79. (In Russ.) https://doi.org/10.21518/ms2025-037.

10. Vatutin NT, Smirnova AS, Taradin GG. Modern inhalation drug delivery devices for treatment of chronic obstructive pulmonary disease. Pulmonologiya. 2015;25(4):477–482. (In Russ.) https://doi.org/10.18093/0869-0189-2015-25-4-477-482.

11. Pedersen S. Inhalers and nebulizers: which to choose and why. Respir Med. 1996;90(2):69–77. https://doi.org/10.1016/s0954-6111(96)90201-2.

12. González-Torralba F, Baloira A, Abad A, Fuster A, García-Rivero JL, GarcíaSidro P et al. FIDEPOC: Consensus on Inspiratory Flow and Lung Deposition as Key Decision Factors in COPD Inhaled Therapy. Int J Chron Obstruct Pulmon Dis. 2022;17:1005–1015. https://doi.org/10.2147/COPD.S360938.

13. Авдеев СН, Айсанов ЗР, Ардашева ТВ, Белевский АС, Бухтияров ИВ, Демко ИВ и др. Хроническая обструктивная болезнь легких: клинические рекомендации. 2024. Режим доступа: https://spulmo.ru/upload/KR-HOBL.pdf.

14. Ray R, Tombs L, Naya I, Compton C, Lipson DA, Boucot I. Efficacy and safety of the dual bronchodilator combination umeclidinium/vilanterol in COPD by age and airflow limitation severity: A pooled post hoc analysis of seven clinical trials. Pulm Pharmacol Ther. 2019;57:101802. https://doi.org/10.1016/j.pupt.2019.101802.

15. Farne HA, Cates CJ. Long-acting beta2-agonist in addition to tiotropium versus either tiotropium or long-acting beta2-agonist alone for chronic obstructive pulmonary disease. Cochrane Database Syst Rev. 2015;(10):CD008989. https://doi.org/10.1002/14651858.CD008989.pub3.

16. Yu AP, Guérin A, Ponce de Leon D, Ramakrishnan K, Wu EQ, Mocarski M et al. Therapy persistence and adherence in patients with chronic obstructive pulmonary disease: multiple versus single long-acting maintenance inhalers. J Med Econ. 2011;14(4):486–496. https://doi.org/10.3111/13696998.2011.594123.

17. Maksimov ML, Bontsevich RA, Shikaleva AA. Modern pharmacotherapeutic approaches to the treatment of chronic obstructive pulmonary disease. Part 2: algorithms from the standpoint of modern clinical guidelines. Therapist. 2024;(11):50–64. (In Russ.) https://doi.org/10.33920/MED-12-2411-06.

18. Cazzola M, Rogliani P, Laitano R, Calzetta L, Matera MG. Beyond Dual Bronchodilation – Triple Therapy, When and Why. Int J Chron Obstruct Pulmon Dis. 2022;17:165–180. https://doi.org/10.2147/COPD.S345263.

19. Lipson DA, Barnacle H, Birk R, Brealey N, Locantore N, Lomas DA et al. FULFIL Trial: Once-Daily Triple Therapy for Patients with Chronic Obstructive Pulmonary Disease. Am J Respir Crit Care Med. 2017;196(4):438–446. https://doi.org/10.1164/rccm.201703-0449oc.

20. Papi A, Vestbo J, Fabbri L, Corradi M, Prunier H, Cohuet G et al. Extrafine inhaled triple therapy versus dual bronchodilator therapy in chronic obstructive pulmonary disease (TRIBUTE): a double-blind, parallel group, randomised controlled trial. Lancet. 2018;391(10125):1076–1084. https://doi.org/10.1016/S0140-6736(18)30206-X.

21. Rabe KF, Martinez FJ, Ferguson GT, Wang C, Singh D, Wedzicha JA, et al. Triple Inhaled Therapy at Two Glucocorticoid Doses in Moderate-to-VerySevere COPD. N Engl J Med. 2020;383(1):35–48. https://doi.org/10.1056/nejmoa1916046.

22. Martinez FJ, Rabe KF, Ferguson GT, Wedzicha JA, Singh D, Wang C et al. Reduced All-Cause Mortality in the ETHOS Trial of Budesonide/Glycopyrrolate/ Formoterol for Chronic Obstructive Pulmonary Disease. A Randomized, Double-Blind, Multicenter, Parallel-Group Study. Am J Respir Crit Care Med. 2021;203(5):553–564. https://doi.org/10.1164/rccm.202006-2618oc.

23. Maksimov ML, Bontsevich RA, Shikaleva AA. Modern pharmacotherapy approaches to treating chronic obstructive pulmonary disease. Part 1: main and additional groups of drugs used in copd therapy. Therapist. 2024;(10):43–61. (In Russ.) https://doi.org/10.33920/MED-12-2410-04.

24. Williams D. The Role of the Pharmacist in Optimizing Outcomes With Roflumilast, a PDE4 Inhibitor for the Treatment of COPD. J Pharm Pract. 2022;35(3):445–454. https://doi.org/10.1177/0897190020969286.

25. Ramakrishnan S, Jeffers H, Langford-Wiley B, Davies J, Thulborn SJ, Mahdi M et al. Blood eosinophil-guided oral prednisolone for COPD exacerbations in primary care in the UK (STARR2): a non-inferiority, multicentre, double-blind, placebo-controlled, randomised controlled trial. Lancet Respir Med. 2024;12(1):67–77. https://doi.org/10.1016/s2213-2600(23)00298-9.

26. Aaron SD. Management and prevention of exacerbations of COPD. BMJ. 2014;349:g5237. https://doi.org/10.1136/bmj.g5237.

27. Trushenko NV, Lavginova BB, Nuralieva GS, Avdeev SN. Clinical efficacy of a triple combination of budesonide/ glycopyrronium bromide/formoterol in the treatment of chronic obstructive pulmonary disease. Meditsinskiy Sovet. 2023;17(20):10–17. (In Russ.) https://doi.org/10.21518/ms2023-382.

28. Bafadhel M, McKenna S, Terry S, Mistry V, Pancholi M, Venge P et al. Blood eosinophils to direct corticosteroid treatment of exacerbations of chronic obstructive pulmonary disease: a randomized placebo-controlled trial. Am J Respir Crit Care Med. 2012;186(1):48–55. https://doi.org/10.1164/rccm.201108-1553oc.

29. Devereux G, Cotton S, Fielding S, McMeekin N, Barnes PJ, Briggs A et al. Effect of Theophylline as Adjunct to Inhaled Corticosteroids on Exacerbations in Patients With COPD: A Randomized Clinical Trial. JAMA. 2018;320(15):1548–1559. https://doi.org/10.1001/jama.2018.14432 .

30. Jenkins CR, Wen FQ, Martin A, Barnes PJ, Celli B, Zhong NS et al. The effect of low-dose corticosteroids and theophylline on the risk of acute exacerbations of COPD: the TASCS randomised controlled trial. Eur Respir J. 2021;57(6):2003338. https://doi.org/10.1183/13993003.03338-2020.

31. Saint-Pierre MD. Evaluating Adherence to the 2023 Canadian Thoracic Society Chronic Obstructive Pulmonary Disease Pharmacotherapy Guidelines: A HospitalBased Study. Ther Adv Pulm Crit Care Med. 2025;20:29768675251336660. https://doi.org/10.1177/29768675251336660.

32. Han SM, Kim HS, Park SY, Lee HB, Park YB, Rhee CK et al. Adherence to Pharmacological Management Guidelines for Stable Chronic Obstructive Lung Disease. Tuberc Respir Dis. 2025;88(2):310–321. https://doi.org/10.4046/trd.2024.0130.

33. Zinnatullina AR, Khamitov RF. Chronic obstructive pulmonary disease: significance of risk factors for frequent exacerbations requiring hospitalization. Pulmonologiya. 2021;31(4):446–455. (In Russ.) https://doi.org/10.18093/0869-0189-2021-31-4-446-455.

34. Bontsevich RA, Zavitkevich GI, Maksimov ML. Evaluation of the effectiveness of advanced training courses for physicians. Farmateka. 2025;32(1):282–287. (In Russ.). Available at: https://pharmateca.ru/ru/archive/article/46699.

35. Bontsevich RA, Sandakova KI, Voronova AE, Zavitkevich GI, Maximov ML. Assessment of the dynamics of specialists’ knowledge on chronic obstructive pulmonary disease during the professional development cycle. Kachestvennaya Klinicheskaya Praktika. 2025;(1):53–63. (In Russ.) https://doi.org/10.37489/2588-0519-2025-1-53-63.


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For citations:

Bontsevich RA, Zavitkevich GI, Batishcheva GA, Nevzorova VA, Tsygankova OV, Rozanova GS, Ketova GG, Martynenko IM, Krotkova IF, Ebzeeva EY, Bikkinina GM, Shabanov EA, Prozorova GG, Tilekeeva UM, Kompaniets OG, Bochanova EN, Luchinina EV, Yormamadov SY, Hasanzoda P, Maximov ML. Pharmacotherapy of chronic obstructive pulmonary disease: Assessment of knowledge of doctors and senior students. Results of the ASCO III study. Meditsinskiy sovet = Medical Council. 2025;(20):50-62. (In Russ.) https://doi.org/10.21518/ms2025-506

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