Reserves for reducing exacerbations in patients with chronic obstructive pulmonary disease at a large industrial enterprise

The clinical course of COPD includes episodes of exacerbation, which become common in the moderate and severe stages of the disease. These episodes increase morbidity and mortality, the use of health system resources, and lead to a loss of productivity and a deterioration in the quality of life (QOL) associated with the health of patients. From an epidemiological point of view, COPD is the third leading cause of death worldwide, and poses a large and growing burden of both direct and indirect costs to society. Objective. To evaluate the effectiveness of preventive measures in patients with chronic obstructive pulmonary disease at a large industrial enterprise during 12 months of follow-up. Material and methods. A one-time survey was conducted of more than 2.000 MMK employees with risk factors: men and women over 40 years of age, with more than 5 years of work experience, with complaints of cough, shortness of breath, and sputum production. The diagnosis of COPD was confirmed in 71 (33%) people. The follow-up group included 25 patients with more than 2 documented exacerbations of COPD, with temporary disability. All patients were prescribed a triple fixed combination, recommended correction of risk factors (smoking cessation), physical activity, and vaccination against pneumococcal infection. The primary endpoint was a 20% reduction in temporary disability within 12 months. The secondary endpoints were: the dynamics of FEV1, the level of dyspnea on the mMRC scale, and a change in the assessment of the impact of COPD on the patient’s health-related quality of life according to the CAT questionnaire. Results. The primary endpoint of the observation has been reached. Temporary disability was 2 cases with an average duration of 3.12 (95% CI 3.03—3.56) days. Functional and clinical parameters significantly improved after 12 months of follow-up. Conclusion. These data indicate that there are reserves in the form of optimizing drug therapy through the use of triple fixed combinations to reduce exacerbations in patients with chronic obstructive pulmonary disease, compared with double fixed combinations.