A recent investigational study of 30,000 respiratory patients across the United States has found that guidelines for treatment are frequently ignored and that treatment of older patients with respiratory conditions is offered to only a small minority of eligible patients.
“Despite the proliferation of numerous guidelines for the management of adults with obstructive respiratory diseases, we found major disparities between the actual care given and that which is recommended,” says lead researcher Benjamin Craig of the Moffitt Cancer Center, Tampa.
Guidelines for treatment usually emphasize the importance of lung function tests, access to inhalers, influenza vaccination, and smoking cessation. Even so, the study authors report that less than 22% of older adults with asthma or COPD received bronchodilator inhalers and 18% did not receive an influenza vaccination.
A large portion of the patients who did not receive proper care were smokers (16%), and the majority were former smokers (53%).
“The finding that smokers receive less care is both troubling and intriguing. There may be a group of patients with such a strong nicotine addiction that quitting would be very difficult. It might be that some of these patients withdraw from care to avoid uncomfortable encounters with physicians who urge smoking cessation. Alternatively, of course, some physicians may dismiss smokers because they have failed to change their behavior,” says Craig.
The study was published in the July 7 edition of BMC Health Services Research.