{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,13]],"date-time":"2025-05-13T04:08:19Z","timestamp":1747109299637,"version":"3.40.5"},"reference-count":51,"publisher":"Georg Thieme Verlag KG","issue":"05","license":[{"start":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T00:00:00Z","timestamp":1729555200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100022535","name":"BERLIN-CHEMIE","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100022535","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pneumologie"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Studiendaten weisen auf Versorgungsl\u00fccken im COPD-Langzeitmanagement mit Diskrepanzen zwischen Leitlinienempfehlungen und deren praktischer Umsetzung hin. Die Gr\u00fcnde sind nur unzureichend bekannt. Ziel der ELETHON-Arztbefragung war die Erfassung \u00e4rztlicher Einstellungen und Meinungen zu allgemeinen Konzepten der COPD-Therapie, und im Speziellen zur Initiierung einer inhalativen Dreifachtherapie.<\/jats:p><jats:p>ELETHON war eine bundesweit durchgef\u00fchrte Querschnittstudie im ambulanten Sektor bei Haus\u00e4rzten und Pneumologen unter Verwendung eines strukturierten Fragebogens (17 geschlossene Single- bzw. Multiple-Choice-Fragen) zu den Themen Sekund\u00e4rpr\u00e4vention, Erfassung von Exazerbationen, Therapieeskalation, Auswahl von inhalativen Dreifachtherapien und Pr\u00fcfung des Therapieerfolgs bei COPD.<\/jats:p><jats:p>Frageb\u00f6gen von n=2028 Haus\u00e4rzten (HA) und n=371\n      Pneumologen (FA) wurden ausgewertet. Beide Gruppen weisen der Sekund\u00e4rpr\u00e4vention bei COPD\n      einen hohen Stellenwert zu (HA\/FA 76,4%\/90,6%), mit Pr\u00fcfung von Inhalationstechnik, Impfstatus\n      und ad\u00e4quater inhalativer Pharmakotherapie als wichtigste Bausteine. Aktivit\u00e4t\/Rehabilitation\n      wurde bei Haus\u00e4rzten deutlich seltener genannt (48,3 vs. 84,5%). Exazerbationen und\n      Symptomverschlechterung gelten als dominierende Parameter f\u00fcr eine Therapieeskalation, werden\n      jedoch mehrheitlich unsystematisch erfasst. Als Schwelle wurden \u201eHospitalisierung\u201c und \u201e\u22652\n      ambulante Exazerbationen\u201c am h\u00e4ufigsten genannt. Eosinophile werden mehrheitlich nicht\n      bestimmt. Bei der Auswahl von Dreifachtherapien werden Festkombinationen bevorzugt, die\n      Verf\u00fcgbarkeit im gleichen Inhalator wie eine Mono- oder duale Therapie als wichtig betont. Der\n      Therapieerfolg wird anhand von Exazerbationen, Lebensqualit\u00e4t, Symptomen, Lungenfunktion und\n      Bedarfsmedikation bewertet. Der COPD Assessment Test (CAT)-Score kommt nur bei wenigen HA\/FA\n      zum Einsatz.<\/jats:p><jats:p>Die ELETHON-Arztbefragung zeigt L\u00fccken im COPD-Management auf. Das Konzept der Sekund\u00e4rpr\u00e4vention wird als wichtig angesehen, dennoch erfolgt eine Therapieeskalation eher sp\u00e4t. Die Bedeutung des Impfstatus deckt sich nicht mit aktuellen Impfquoten, nicht-pharmakologische Ma\u00dfnahmen werden unzureichend genutzt. Die Erfassung von Exazerbationen und Symptomatik erfolgt unsystematisch; validierte Frageb\u00f6gen und Eosinophile haben nur einen untergeordneten Stellenwert. ELETHON liefert wichtige Erkenntnisse zu Barrieren und versteckten Potenzialen im Versorgungsalltag der COPD bei Haus- und Fach\u00e4rzten in Deutschland.<\/jats:p>","DOI":"10.1055\/a-2414-4197","type":"journal-article","created":{"date-parts":[[2024,10,22]],"date-time":"2024-10-22T23:22:02Z","timestamp":1729639322000},"page":"366-376","source":"Crossref","is-referenced-by-count":0,"title":["Einsatz von langwirksamen Dreifachkombinationen in der Praxis zur Therapie der chronisch-obstruktiven Lungenerkrankung (COPD) \u2013 Die ELETHON-Versorgungsstudie"],"prefix":"10.1055","volume":"79","author":[{"given":"Kai-Michael","family":"Beeh","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Atemwegsforschung GmbH, insaf, Taunusstein, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0807-4851","authenticated-orcid":false,"given":"Saskia","family":"Kr\u00fcger","sequence":"additional","affiliation":[{"name":"Medical Department, Berlin-Chemie AG, Berlin, Deutschland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2024,10,22]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"421","DOI":"10.1016\/j.ccm.2020.06.007","article-title":"Definition, Causes, Pathogenesis, and Consequences of Chronic Obstructive Pulmonary Disease Exacerbations","volume":"41","author":"AI Ritchie","year":"2020","journal-title":"Clin Chest Med"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"449","DOI":"10.1586\/ers.09.40","article-title":"Preventing chronic obstructive pulmonary disease","volume":"3","author":"DM Halpin","year":"2009","journal-title":"Expert Rev Respir Med"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1183\/13993003.00164-2019","article-title":"Global Strategy for the Diagnosis, Management, and Prevention of Chronic\n          Obstructive Lung Disease: the GOLD science committee report 2019","volume":"53","author":"D Singh","year":"2019","journal-title":"Eur Respir J"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1164\/rccm.201703-0449OC","article-title":"FULFIL Trial: Once-Daily Triple Therapy in Patients with Chronic Obstructive\n          Pulmonary Disease","volume":"196","author":"DA Lipson","year":"2017","journal-title":"Am J Respir Crit Care Med"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1671","DOI":"10.1056\/NEJMoa1713901","article-title":"Once-Daily Single-Inhaler Triple versus Dual Therapy in Patients with\n          COPD","volume":"378","author":"DA Lipson","year":"2018","journal-title":"N Engl J Med"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"35","DOI":"10.1056\/NEJMoa1916046","article-title":"Triple Inhaled Therapy at Two Glucocorticoid Doses in Moderate-to-Very-Severe\n          COPD","volume":"338","author":"KF Rabe","year":"2020","journal-title":"N Engl J Med"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"1076","DOI":"10.1016\/S0140-6736(18)30206-X","article-title":"Extrafine inhaled triple therapy versus dual bronchodilator therapy in chronic obstructive pulmonary disease (TRIBUTE): a double-blind, parallel group, randomised controlled trial","volume":"391","author":"A Papi","year":"2018","journal-title":"Lancet"},{"key":"ref13","doi-asserted-by":"publisher","first-page":"689","DOI":"10.1164\/rccm.202005-1854OC","article-title":"Pharmacotherapy and Lung Function Decline in Patients with Chronic Obstructive\n          Pulmonary Disease. 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