Comparison of the effectiveness of the application of various schemes for the treatment of bronchial asthma and COPD in a supra-cluster level of care institution

Abstract

Bronchial asthma and COPD are among the most common diseases with bronchoobstructive syndrome, however, the effectiveness of various treatment regimens using them is still debatable.The aim of the study – studying the effectiveness of using different treatment regimens for the most common diseases with broncho-obstructive syndrome using the example of the pulmonology department of the tertiary care institution.Materials and methods. A total of 203 medical histories and data from the medical information system MedAir were analyzed, followed by an evaluation of the effectiveness of applied treatment regimens using Farrell's technical efficiency index, cost-effectiveness analysis, and related factors.Results. The analysis showed low adaptability of basic therapy regimens for patients with bronchial asthma (BA) and chronic obstructive pulmonary disease (COPD). Technical effectiveness of treatment was achieved in only 5.2% of patients (5 out of 97), while the majority received excessive (69%) or insufficient (28%) doses of drugs. Overall treatment effectiveness was higher in patients with BA (78%) compared to patients with COPD (62%). Among the three analyzed treatment regimens, the first was the most effective in terms of technical parameters (84%), the second – in terms of cost-effectiveness (76%), and the third achieved the highest indicators in terms of both criteria (88% technical effectiveness and 82% cost-effectiveness). However, conclusions regarding the third regimen are limited due to the small number of observations (12 patients). Factors affecting cost-effectiveness were gender, diagnosis, and year of observation. Women responded better to the first treatment regimen (82%), while the second regimen was more effective for employed men (71%). Patients with asthma showed a higher treatment efficacy (12% more compared to COPD). Although patient compliance was positively correlated with treatment outcomes, its effect was not statistically significant.