Why do Patients undergoing Chronic Obstructive Pulmonary Disease Treatment Turn Defaulters ? A Follow –up Study in a Tertiary Care Hospital in Jamnagar, India LC04-LC06
Dr. Pradeep Pithadia,
Assistant Professor, Department of Community Medicine, Shri MP Shah Govt. Medical College, Jamnagar, Gujarat, India.
Introduction: Chronic Obstructive Pulmonary Disease (COPD), a progressive respiratory illness requiring long-term treatment, is a significant cause of morbidity, mortality and economic burden on the family as well as the country. In the tertiary health care facility where the study was carried out, it was observed that many COPD patients did not come for regular follow-up. In these patients, treatment interruption may lead to increased morbidity and mortality.
Aim: This study aimed to find out the reasons for defaulting follow-up and treatment in COPD patients.
Materials and Methods: All patients of COPD, attending TB Chest outpatient department during the study period (September 2012 to February 2013), were classified into Group A, B, C, and D according to latest Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. Data was collected on patientís socio-demographic profile, severity of disease and reasons for defaulting follow-up and treatment using pre-tested semi-structured questionnaires, patient history and clinical examination. Data obtained were entered in Microsoft Office Excel 2007 and analysed using Chi-square test.
Results: The mean age of the 200 patients recruited was 59.3 years. A total of 87% patients were male. Patients belonging to Group A, B, C and D were 11%, 25.5%, 41.5% and 22% respectively. Overall, 32% patients were defaulters. Three main reasons for default were non-affordability for treatment expenses (39.07%), resolution of symptoms (26.56%), and too ill to come (18.75%). The associations between default rate and demographic variables like age and gender were found statistically significant.
Conclusion: Default rate among COPD patients is significantly associated with GOLD Group A and D, patientís income and patient literacy level. Main reasons for default were non-affordability of treatment expenses and too ill to come or resolution of symptoms.