Abstract

COMPREHENSIVE ANALYSIS OF SMOKING CESSATION, PHARMACOLOGICAL AGENTS AND BIOMARKERS IN COPD PATIENTS

Bayana H., Blessy Cherian, Farsana Rasheed, Telma Titto, Naveen Kumar Panicker* and Amit P. Jose

ABSTRACT

Background: Chronic obstructive pulmonary disease (COPD) remains a major cause of morbidity and mortality in developed countries and is emerging as a major disease in developing economies. The purpose of this study was to assess the effects of smoking cessation strategies in COPD patients, classify COPD patients based on GOLD ABE assessment tool (2023), to study the association of Neutrophil lymphocyte ratio and eosinophil count in COPD exacerbation and to document the prescribing pattern for COPD management. Materials and methods: A prospective study was conducted on COPD patients in Pulmonology Department of a tertiary care hospital for a period of six months. Details on demographics, comorbidities and drugs used in management of COPD were recorded. Smokers were identified from the data collected from sample population. Patients were counseled with the aid of specially designed leaflets and follow up at 1 month and 3 months to analyze the smoking habits. Pulmonary function test, blood test, Modified MRC Dyspnea Scale, CAT Assessment tool was assessed. Results: The study included 107 COPD patients who were divided into categories based on gender, age, and comorbidities. The average age of the entire population was 66.75 years. To assess the effect of smoking cessation strategies in COPD patients, the smokers were included over a period of 6 months with follow up at an interval of 1 month and 3 months. A whatsapp group “LETS DO IT” was created that offered continuous support and sense of community, daily motivational videos kept the participants engaged and regular follow ups were conducted. Patients were classified into three groups-A, B and E (GOLD guidelines 2023) by the COPD symptoms as determined by CAT or Mmrc and the history of exacerbations in the preceding year. To study the association of neutrophil lymphocyte ratio and eosinophil count in COPD exacerbation, the NLR was calculated with the ratio between B-Neu to B- Lym. Bronchodilators, mucolytics, corticosteroids, and leukotriene antagonists were the most commonly used pharmacological agents in the management of COPD. Conclusion: By clinical pharmacist intervention, smoking cessation program was initiated that could bring positive results. The study also classified patients according to the latest updated GOLD 2023 ABE assessment tool. Association of neutrophil lymphocyte ratio and eosinophil count in COPD exacerbation were analysed and found to be insignificant in our study. The most commonly prescribed drugs used in the management of COPD were bronchodilators and Cephalosporins were the most commonly prescribed antibiotics used for the management of secondary infection in COPD.

Keywords: COPD, Bronchodilators, pneumoconiosis, bronchopneumonia, pulmonary embolism.