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ASSESSMENT OF PHYSICIANS’ AND SENIOR MEDICAL STUDENTS’ KNOWLEDGE IN TREATMENT OF PATIENTS WITH COMMUNITY-ACQUIRED PNEUMONIA. CURRENT RESULTS OF THE KNOCAP PROJECT

Introduction: Community-acquired pneumonia (CAP) remains one of the most acute problems of bronchopulmonary pathology being the 4th in the mortality structure (after cardiovascular, cerebrovascular diseases and malignant neoplasms) and the 1st among all fatalities from infectious diseases. Thanks to the scientific progress achieved in the antibiotic therapy and vaccine prophylaxis, the death toll has decreased four times compared to its rate during the “pre-antibiotic era“. However, nowadays there is a steadily increasing trend in the pneumonia mortality rate in Russia. The only possible way to increase efficacy of CAP treatment is timely initiated rational antibiotic therapy, considering the possible etiologies, risk factors and the severity of the patient's condition.

Materials and Methods: The article represents the results of anonymous prospective surveys within the framework of the KNOCAP multi-centered research project aimed at accessing the knowledge on the fundamental issues in diagnosis and treatment of community-acquired pneumonia. The survey involved 222 students in their fifth- and sixth years in medical institute from Belgorod, Dnepr (Dnipro), Voronezh, Kiev (Kyiv) and Saratov and 110 physicians from Krasnodar, Saratov, Belgorod and Dnepr.

Results and Discussion: According to the results of the survey, such levels of correct answers were given by doctors and students, respectively: the inadmissibility of antimicrobial therapy (AMT) delay in CAP - 82% and 59%; the main criterion for withholding AMT - 56% and 37%; "sequential therapy" - 61% and 59%. At the same time, only 24% of the students and 23% of the physicians surveyed correctly reported typical mistakes in the treatment of a non-severe CAP with 50% or more accuracy; and in case of initial treatment, the number of correct responses was less than 28% for students and 45% for doctors.

Conclusion: The survey showed that both senior medical students majoring in Medical Care and general practitioners had a low level of knowledge in CAP treatment. Hence, curricula need to be adjusted both in medical universities and in health institutions for practitioners in order to inform them and, thus, improve the quality of their knowledge in this field.

Иллюстрации

Figure 1. Preferred choice of regulatory documents for the treatment of CAP patients

Figure 2. Responses to the question about reasons for a delayed onset of AMT in patients with a confirmed diagnosis of CAP

Figure 3. Responses to the question about the main criterion for termination antimicrobial therapy

Figure 4. Responses to the question about sequential therapy for CAP

Figure 5. Responses to the question about typical mistakes in CAP treatment

Figure 6. Distribution of answers concerning the choice of optimal initial therapy for a non-severe CAP in patients with neither risk factors nor concomitant diseases

Figure 7. The main mistakes in the groups of students and doctors (both groups together) when selecting an initial therapy for a non-severe CAP in patients with neither risk factors nor concomitant diseases

Figure 8. Responses to the questions about an initial therapy for a non-severe CAP in patients with risk factors and/or concomitant diseases

Figure 9. The main mistakes in the groups of students and doctors (both groups together) when selecting an initial therapy for a non-severe CAP in patients with risk factors and/or concomitant diseases

Figure 10. Distribution of incorrect answers to all questions in groups of doctors and students

DOI: https://doi.org/10.3897/rrpharmacology.4.29454
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