Perbandingan Frekuensi Eksaserbasi pada Pasien Penyakit Paru Obstruktif Kronis (PPOK) antara Penerima Monobronkodilator dan Dual Bronkodilator di Rumah Sakit Umum H. Adam Malik Medan dan Rumah Sakit Prof. CPL USU

Abstract

Background: Chronic Obstructive Pulmonary Disease (COPD) poses a significant global health burden, with high exacerbation rates persisting despite long-term bronchodilator therapy, particularly in elderly male smokers in Indonesia. Uncertainty remains regarding the effectiveness of monobronchodilators versus dual bronchodilators in a real-world setting. Objective: This study compared the frequency of exacerbations in COPD patients receiving monobronchodilator and dual bronchodilator therapy. Type and Methods of the Study: Quantitative study with a retrospective cohort design in two tertiary referral hospitals in Indonesia (H. Adam Malik General Hospital Medan and Prof. CPL USU Hospital), January–June 2025. Population and Sample: Patients ≥40 years with COPD (ICD-10 J44); a purposive sample of 268 patients (134 per group) who met the inclusion criteria (≥3 months of therapy, complete records). Instruments and Data Analysis Techniques: Standardized extraction form and codebook; descriptive statistics, Chi-square test, Poisson regression.Results: The monobronchodilator group showed higher exacerbations (15/53, 28.3%) than the dual (2/52, 6.3%), p= 0.014.Conclusion: Dual bronchodilator therapy (LABA/LAMA) significantly reduced the frequency of exacerbations compared to monotherapy, supporting its application in high-risk COPD patients.