Exacerbation in COPD:a web platform to evaluate, in real-life, COPD management in the Apulia Region (Italy)

Introduction: the COPD exacerbations are associated with a high mortality rate, a faster decline in lung function, poor quality of life and increased health resource utilization. Aims and objectives: to evaluate COPD management in Apulia region. In this context, an “Exacerbation in COPD " study was performed in collaboration between pulmonology centers and the Regional Health Agency (AReS Puglia). Methods: an IT platform developed by the Interuniversity Consortium CINECA allowed pulmonologists the insertion of data via internet. The project lasted 18 months and involved 11 centers. Results: 764 patients were enrolled (16% female and 84% male), evenly distributed throughout the region. The platform allowed the classification of patients according to GOLD guidelines (Group A 22%, B 33.6%, C 5.9% D 38.4%), assess the presence and severity of exacerbations (19.9% had an exacerbation at the moment of the visit, respectively slight 13%, 37% mild and 49% severe) and evaluate the appropriateness of inhalation therapy at the time of the visit. We found that 49% of group A patients were following inappropriate therapy, with 14% already in ICS/LABA+LAMA; in group B, 34% of patients were following a triple combination therapy and 31% used ICS, in contrast with guidelines. Among group C patients, 41% resulted in triple combination therapy, while 22% of group D patients did not have a therapy or used a single drug. In conclusion, 47% of all patients evaluated had been following an inadequate therapy. Conclusion: the data provide an overview on the management of COPD in the Apulia region and represent a resource in order to improve appropriateness and reduce the waste of health resources.