TOPICAL ISSUES OF COPD MANAGEMENT IN GEORGIA.

Chronic obstructive pulmonary disease (COPD) is the major cause of chronic morbidity and mortality throughout the world. USAID Health Care Improvement Project (HCI) had collaborated with the Ministry of Labor, Healthcare and Social Affairs of Georgia in 2012-2014 to improve quality of care for high-burden and under-diagnosed diseases, including asthma and COPD. The Aim of the study was to evaluate the effectiveness (quality, consistency and continuity) of medical care in COPD patients in one of the regions of Georgia after 5 years from the ending of the project. The received results of our research were compared to the data from USAID HCI Project. In order to evaluate the effectiveness of medical care, 7 rural primary care units and 1 hospital have been selected. Information was gathered with standardized questionnaires: from providers, patients and medical records: 42 physicians and 83 patients were interviewed, 152 medical records were reviewed. Research period was defined from March 2017 till March 2019. Research protocol is approved by an Ethical Committee Review Board at ATSU. All indicators showing the quality and effectiveness of COPD management (prescription of COPD controller medications, bronchodilators, documented procedures, etc) are improved. Improvement tendency is obvious in all aspects of treatment/management, except spirometry results recorded, which is 4% less compared to the project results. Documentation from the primary care units showed decreased indicator of counseling provided for smoking cessation by 9%. Based on our data the sustainability in the treatment and management of COPD is still in progress. Two main areas need to be paid special attention to: patient consultation/education and timely diagnosis of the disease.