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Résumé : Introduction : Les exacerbations de BPCO (EABPCO) représentent un poids économique lourd pour notre système de santé et aggravent le pronostic de la maladie. C'est également le meilleur facteur prédictif d'exacerbations ultérieures. Le traitement des EABPCO est bien codifié et repose sur les recommandations des sociétés savantes nationales et internationales. La prévention des EABPCO doit être systématique et passe par l'arrêt du tabac, les vaccins, le traitement de fond, Team on behalf of the ECA, vol.68, pp.1169-71, 2013. ,
, Une première analyse a été réalisée en diffusant des recommandations locales en 2011. Nous avons analysé les pratiques professionnelles à distance de la diffusion des recommandations afin d'évaluer le degré de persistance de l'adhérence des pratiques cliniques aux recommandations. Cela a été réalisé par une étude rétrospective, Matériels et méthodes : L'évaluation des pratiques professionnelles, 2016.
, La prescription de salbutamol a diminué significativement (p<0.001) en période 3 (4%) par rapport à la période 1 (59%) alors que la prescription de sulfate de magnésium intraveineux a augmenté en période 3 (34,9%) par rapport à la période 2 (12,9%) sans être significatif (p=0.091). La prescription d'aérosols a globalement diminué de J1 à J5 en période 3 par rapport aux périodes 1 et 2. La corticothérapie à dose recommandée a, Résultats : Un total de 189 patients a été inclus dont 32 en période 1 (entre 2010 et 2011, soit l'année précédant la diffusion des recommandations)
, La consultation anti-tabac post-exacerbation avait diminué significativement en période 3 (6,8% des patients non sevrés) mais le nombre de patients ayant eu un sevrage tabagique après l'hospitalisation avait légèrement progressé en période 3 (18,6%). La consultation pneumologique de suivi a été réalisée chez 73% des patients, L'antibiothérapie prescrite selon les recommandations s'est améliorée en période 3 (88,1%) par rapport à la période 1 (62,5%) et la période 2 (87,1%)
, Discussion: Les pratiques professionnelles en accord avec les recommandations persistent en partie à distance. Le sulfate de magnésium, la kinésithérapie, la réalisation des antigénuries et l'organisation du suivi après l'hospitalisation après l'hospitalisation nécessitent une harmonisation avec les recommandations. Une mise à jour régulière des connaissances et la réalisation d'EPP
, Mots-clés: BPCO, exacerbation, évaluation, pratiques professionnelles, recommandations