Copd case studies uk
Consistent with this finding, approximately half of the patients who had not experienced an exacerbation in the year prior to data extraction were receiving ICS. Some patients receive no treatment despite experiencing symptoms.
Of those patients receiving no treatment, This is consistent with other retrospective cohort studies in the UK. In a subset of patients with moderate airflow limitation, 223 data were also analyzed by exacerbation history moderate and severe exacerbation ratemMRC score, and CAT score.
The majority of patients with no exacerbations were in Group A The distribution of patients according to GOLD stages was Potential differences between the characteristics of patients who returned questionnaires and those who did not cannot be discounted as a possible source of bias.
This difference in GOLD group distribution depending on whether the mMRC score or CAT score is used highlights the difficulty facing primary-care physicians when making treatment decisions in real-life practice and illustrates how guidelines may only provide limited assistance. The mean age was These differences are the largest, in relative terms, for any of the major lung diseases. In summary, this analysis of UK prescribing patterns indicates that COPD management choices do not usually follow GOLD recommendations and NICE guidelines, in particular those relating to the use of ICS and long-acting bronchodilators, which results in a substantial proportion of patients not being treated or not receiving the most appropriate medication. By bringing in these changes she expected to see improvements in patient outcomes, increased empowerment in the practices of patients and reduce the number of missed appointments they were experiencing. The distribution of patients according to GOLD stages was This may be expected to influence treatment outcomes because depression, in particular, is associated with poor compliance and negatively impacts on smoking cessation. Events were considered to be the result of the same exacerbation and only counted once if any of the three elements hospitalization, oral steroid prescription, or lower respiratory tract infection consultation occurred within 2 weeks of another. Of the patients in the high-risk groups, C and D, Note: Data were extracted in May The objective of this study was to evaluate the current management of patients with COPD using real-life data generated in the UK primary-care setting. As this is a retrospective analysis, it is not possible to conclude whether the treatment patterns are a response to symptoms or whether the symptoms show lack of response to treatment.
Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Discussion The present study, one of the largest to evaluate real-life treatment patterns of COPD in the UK, indicates that COPD is often not managed in primary care according to the most recent recommendations and guidelines.
We interviewed subjects of different age, gender, smoking and employment statuses to ensure we obtained a range of perspectives. The objective of this study was to evaluate the current management of patients with COPD using real-life data generated in the UK primary-care setting. Abstract Background COPD is a leading cause of morbidity and mortality, yet it remains largely under-diagnosed. New research is required to see if this is still valid, and to ascertain the current prevalence of the disease. Of the patients with exacerbations in the year prior to data extraction, Increasing public awareness of COPD risk factors and early symptoms may enhance case-finding. We invited patients from different parts of the case-finding process with the aim of eliciting a range of views on the key steps of case-finding.
Field notes alone were used for the remaining two patient interviews. There were no major demographic differences across GOLD groups in terms of age, sex, and smoking status Table 1. The analyses using CAT scores were conducted in a subset of patients because, unlike mMRC scores that were determined from questionnaire data or patient records, CAT scores could only be calculated from patient questionnaires, which were not available for all patients.
Copd incidence uk
Patients and methods Semistructured interviews were conducted with adults, aged 40 years or older with a history of smoking, who were eligible and invited for case-finding for COPD as a part of a large UK primary care trial. Based on degree of airflow limitation, symptoms mMRC score , and history of exacerbations, the 23, Overall, patients who returned the questionnaire, as compared with those who did not, tended to be slightly older The practice nurse adapted the way asthma reviews were conducted including the templates to record the data collected so they followed best practice. Only data for patients with a COPD diagnosis quality and outcomes framework diagnostic code , 24 1 year of practice data prior to last data extraction and no leaving date, spirometry supportive of COPD diagnosis within 5 years of data extraction, and last data extraction date after were included in this retrospective analysis. Of the patients with no exacerbations, From the 58 patients who were willing to be interviewed, purposive sampling was used to recruit a diverse range of patients, in terms of age, sex, and smoking and employment statuses.
Patients also show a better understanding of medicines use including the implications of overuse of salbutamol inhalers as this can increase the risk of asthma attacks.
based on 44 review