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Guidelines for Care of Elderly Patients With Respiratory Conditions Ignored LONDON -- July 8, 2008 -- Guidelines for the treatment of older patients with respiratory conditions are routinely ignored and recommended treatments are given to only a small minority of eligible patients, according to research published in the open access journal BMC Health Services Research. Benjamin Craig, PhD, Moffitt Cancer Center, Tampa, Florida, led a team who investigated the treatment of nearly 30,000 patients across the United States. "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," said Dr. Craig. Chronic obstructive pulmonary disease (COPD) and asthma are leading causes of death in people aged over 45 years in the United States. Guidelines emphasise the importance of lung function tests, access to inhalers, influenza vaccination, and smoking cessation. However, according to the study, "slightly less than 22% of older adults with asthma or COPD received bronchodilator inhalers," said Dr. Craig. "An even smaller minority received 1 or more lung function examinations during the year, and 18% were not vaccinated against influenza." Of the patients, 16% were smokers and 53% were former smokers. The researchers found that current smokers were less likely to receive care than those who had never smoked or who had quit. "The finding that smokers receive less care is both troubling and intriguing," said Dr. Craig. "… 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 behaviour." The researchers conclude that the needs of older adults with obstructive respiratory disease and possible nicotine addiction deserve special attention and that guidelines require further development and much wider implementation. SOURCE: Biomed Central E-mail this page to a friend or colleague! To print, use this version