Specialist respiratory outreach: a case-finding initiative for identifying undiagnosed COPD in primary care

Ray, Emma, Culliford, David, Kruk, Helen, Gillett, Kate, North, Mal, Astles, Carla M., Hicks, Alexander, Johnson, Matthew, Lin, Sharon Xiaowen, Orlando, Rosanna, Thomas, Mike, Jordan, Rachel E., Price, David, Konstantin, Mita and Wilkinson, Tom M. A. (2021) Specialist respiratory outreach: a case-finding initiative for identifying undiagnosed COPD in primary care. NPJ primary care respiratory medicine, 31 (1), [7]. (doi:10.1038/s41533-021-00219-x).

Abstract

COPD remains largely undiagnosed or is diagnosed late in the course of disease. We report findings of a specialist outreach programme to identify undiagnosed COPD in primary care. An electronic case-finding algorithm identified 1602 at-risk patients from 12 practices who were invited to attend the clinic. Three hundred and eighty-three (23.9%) responded and 288 were enrolled into the study. Forty-eight (16.6%) had undiagnosed mild and 28 (9.7%) had moderate airway obstruction, meeting spirometric diagnostic criteria for COPD. However, at 12 months only 8 suspected COPD patients (10.6%) had received a diagnostic label in their primary care record. This constituted 0.38% of the total patient population, as compared with 0.31% of control practices, p = 0.306. However, if all patients with airway obstruction received a coding of COPD, then the diagnosis rate in the intervention group would have risen by 0.84%. Despite the low take-up and diagnostic yield, this programme suggests that integrated case-finding strategies could improve COPD recognition.

This record has no associated files available for download.

Contributors

Author: David Culliford

Author: Rosanna Orlando

Download statistics