Inaccurate diagnosis of COPD: the Welsh National COPD Audit.
Inaccurate diagnosis of COPD: the Welsh National COPD Audit. Br J Gen Pract. 2018 Dec 17;: Authors: Fisk M, McMillan V, Brown J, Holzhauer-Barrie J, Khan MS, Baxter N, Roberts CM Abstract BACKGROUND: The diagnosis of chronic obstructive pulmonary disease (COPD) is confirmed with spirometry demonstrating persistent airflow obstruction. AIM: To evaluate the clinical characteristics and management of patients in primary care on COPD registers with spirometry incompatible with COPD. DESIGN AND SETTING: A primary care audit of Welsh COPD Read-Coded patient data from the Quality and Outcomes Framework (QOF) COPD register in Wales. METHOD: Patients on the QOF COPD register with incompatible spirometry (post-bronchodilator forced expiratory lung volume in 1 second/forced vital capacity [FEV1/FVC] ratio ≥0.70) were compared with those with compatible spirometry (FEV1/FVC
ConclusionsThis large observational study based on claims data reliably identified subjects with COPD treated with open TT and their burden on the NHS. Moreover, it could describe the real clinical management of the open TT, before the marketing of the fixed one. These findings are useful for health policymakers in order to promote the appropriate utilization of both currently marketed and future therapies.
Conclusion: In this group of pulmonologists confirmed COPD or ACO patients, a substantial proportion would be considered to have signs of asthma. In the personalized approach of airway disease management, these patients might benefit from ICS containing treatment. Prospective studies are needed to guide personalized care in this patient group.
Background and Objective: Inhaled corticosteroids (ICS) might be overprescribed for COPD in general practice. Our aim was to identify predictors for prescribing ICS for COPD patients with or without asthma in general practice.Methods: Participating general practitioners (GPs) (n=144) recruited patients with COPD (ICPC 2nd ed. code R95) and currently prescribed ICS (ACT code R03AK and R03BA). Data on demographics, smoking habits, spirometry, dyspnea score, and exacerbation history were retrieved from medical records. Pearson Chi-Square test was used for comparison of categorical variables and logistic regression analysis wa...
Conclusion: A high proportion of COPD/Asthma patients are treated with oral medications in India. Even though 34% of patients are prescribed inhaled medications before they reach tertiary care, there is a preference for a ICS over LAMA in COPD and only 30% of Asthma patients were prescribed an ICS.
ConclusionsPotentially inappropriate ICS use is common among patients with and without airflow obstruction who are diagnosed with COPD. We identified patient comorbidities and patterns of healthcare utilization that increase the likelihood of ICS use that could be targeted for system-level de-implementation interventions.
Mario Malerba1,2*, Valentina Foci1,2, Filippo Patrucco1,2, Patrizia Pochetti1,2, Matteo Nardin3, Corrado Pelaia4 and Alessandro Radaeli5 1Respiratory Medicine, Department of Translational Medicine, University of Eastern Piedmont, Vercelli, Italy 2Respiratory Unit, Sant’Andrea Hospital, Vercelli, Italy 3Department of Medicine, Spedali Civili di Brescia, Brescia, Italy 4Department of Medical and Surgical Sciences, Section of Respiratory Diseases, University “Magna Græcia” of Catanzaro, Catanzaro, Italy 5Department of Emergency, Spedali Civili di Brescia, Brescia, Italy Chronic obstructiv...
ConclusionWhile most PCPs and respiratory/allergy specialists can reach a working diagnosis of ACO, there remains uncertainty around which diagnostic features are most important and what constitutes optimal management. It is imperative that clinical studies including patients with ACO are initiated, allowing the generation of evidence ‐based management strategies.This article is protected by copyright. All rights reserved.
Conclusion: Although only one third of the COPD patients seen in primary care were treated with ICS, our findings suggest that management of those COPD patients prescribed ICS could be tailored more precisely to the characteristics of the individual patient.
Identification of treatable traits is proposed as a precision medicine approach for asthma and COPD. We sought to characterise the pulmonary treatable traits in patients attending the Oxford Centre for Respiratory Medicine (2014-2017).Adults with a physician diagnosis of asthma or COPD were recruited (n=214). Clinical demographics, medication use and medical history was recorded. Whole blood, induced sputum, and spirometry with reversibility and disease specific symptoms were assessed. Qualitative CT reports were recorded within 2 years of the study visit.The cohort were older adults (mean age 55 years, 53% female) who wer...
Conclusion: Significant disagreement exists between physician-diagnosis and guideline-derived diagnosis among management of community patients with SOB symptoms. Most patients are prescribed inhalers without a PFT diagnostic workup. This may be in part due to the inadequate understanding of PFT interpretation and usage by family-care physicians.