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

Emma Ray, David Culliford, Helen Kruk, Kate Gillett, Mal North, Carla M Astles, Alexander Hicks, Matthew Johnson, Sharon Xiaowen Lin, Rosanna Orlando, Mike Thomas, Rachel E Jordan, David Price, Mita Konstantin, Tom M A Wilkinson

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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.

Original languageEnglish
Article number7
Number of pages8
JournalNPJ Primary Care Respiratory Medicine
Volume31
Issue number1
Early online date11 Feb 2021
DOIs
Publication statusPublished - Dec 2021

Keywords

  • Humans
  • Primary Health Care
  • Pulmonary Disease, Chronic Obstructive/diagnosis
  • Spirometry

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