A Descriptive Study of the Clinical Practice Guideline and Patient Profiles of Chronic Obstructive Pulmonary Disease at Phetchabun Hospital

Abstract

This study aimed to describe the actual clinical practices and general characteristics of patients with chronic obstructive pulmonary disease (COPD) attending Phetchabun Hospital. Data were collected through interviews with a multidisciplinary team and review of patient medical records in the COPD clinic, using a structured interview guide and data collection form. Data were analyzed using content and descriptive analyses. The COPD clinic operated as a multidisciplinary service, beginning with screening through history taking and risk factor assessment. Suspected COPD patients underwent pulmonary function testing, and those with post-bronchodilator FEV1/FVC < 0.7 were registered and followed up by the multidisciplinary team. Patients were assessed for dyspnea using the Modified Medical Research Council Dyspnea Scale (mMRC) and COPD Assessment Test (CAT), and evaluations included medication use, exacerbations, comorbidities, and smoking status. Physiotherapists conducted the Six-Minute Walk Test (6MWT) and provided pulmonary rehabilitation, including pursed-lip and diaphragmatic breathing, chest mobility exercises, muscle training, and endurance-enhancing exercise, supplemented with a home exercise guide. Between May 2015 and May 2023, 156 patients attended the clinic, most of whom were male (74.35%) and over 70 years old (52.56%). The majority had COPD for ≤5 years (60.26%) and no comorbidities (78.20%). The mean FEV1/FVC was 50.23±18.18, and disease severity was predominantly severe (41.08%). The mean CAT and mMRC scores were 8±6.56 and 1±0.76, respectively. Overall, 24.66% of patients participated in the 6MWT and received pulmonary rehabilitation. The findings reflected actual COPD care and provided essential information to support the development of more effective service models and clinical practice guidelines.