Diagnosis and Management of Chronic Obstructive Pulmonary Disease (COPD) in a Primary Care Clinic

2009 ◽  
Vol 6 (6) ◽  
pp. 446-451 ◽  
Author(s):  
Pompeyo C. Chavez ◽  
Navkiran K. Shokar
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Primary Care ◽  
Pulmonary Disease ◽  
Primary Care Clinic ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Care Clinic ◽  
Diagnosis And Management

scholarly journals The feasibility of an innovative GP-physiotherapist partnership to identify and manage chronic obstructive pulmonary disease (INTEGRATED): study protocol

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Lisa Pagano ◽  
Zoe McKeough ◽  
Sally Wootton ◽  
Stephen Crone ◽  
Deborah Pallavicini ◽  
...  
Keyword(s):  
Physical Activity ◽  
Chronic Obstructive Pulmonary Disease ◽  
Primary Care ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Model Of Care ◽  
Obstructive Pulmonary Disease ◽  
Diagnosis And Management ◽  
Number Of Patients ◽  
A Current

Abstract Background Chronic obstructive pulmonary disease (COPD) contributes significantly to mortality, hospitalisations and health care costs worldwide. There is evidence that the detection, accurate diagnosis and management of COPD are currently suboptimal in primary care. Physiotherapists are well-trained in cardiorespiratory management and chronic care but are currently underutilised in primary care. A cardiorespiratory physiotherapist working in partnership with general practitioners (GPs) has the potential to improve quality of care for people with COPD. Methods A prospective pilot study will test the feasibility of an integrated model of care between GPs and physiotherapists to improve the diagnosis and management of people with COPD in primary care. Four general practices will be selected to work in partnership with four physiotherapists from their local health district. Patients at risk of developing COPD or those with a current diagnosis of COPD will be invited to attend a baseline assessment with the physiotherapist, including pre- and post-bronchodilator spirometry to identify new cases of COPD or confirm a current diagnosis and stage of COPD. The intervention for those with COPD will involve the physiotherapist and GP working in partnership to develop and implement a care plan involving the following tailored to patient need: referral to pulmonary rehabilitation (PR), physical activity counselling, medication review, smoking cessation, review of inhaler technique and education. Process outcomes will include the number of people invited and reviewed at the practice, the proportion with a new diagnosis of COPD, the number of patients eligible and referred to PR and the number who attended PR. Patient outcomes will include changes in symptoms, physical activity levels, smoking status and self-reported exacerbations. Discussion If feasible, we will test the integration of physiotherapists within the primary care setting in a cluster randomised controlled trial. If the model improves health outcomes for the growing numbers of people with COPD, then it may provide a GP-physiotherapist model of care that could be tested for other chronic conditions. Trial registration ANZCTR, ACTRN12619001127190. Registered on 12 August 2019—retrospectively registered.

scholarly journals Modern Innovative Solutions in Improving Outcomes in Chronic Obstructive Pulmonary Disease (MISSION COPD): Mixed Methods Evaluation of a Novel Integrated Care Clinic

2019 ◽  
Vol 8 (4) ◽  
pp. e9637 ◽  
Author(s):  
Eleanor Lanning ◽  
Jayne Longstaff ◽  
Thomas Jones ◽  
Claire Roberts ◽  
Daniel Neville ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Primary Care ◽  
Pulmonary Disease ◽  
Hospital Admissions ◽  
Patient Activation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Care Clinic ◽  
Patient Reported ◽  
Innovative Solutions

Background Chronic obstructive pulmonary disease (COPD) is the second-leading cause of death in the United Kingdom and accounts for 1.7% of bed days in acute hospitals. An estimated two-third of patients with COPD remain undiagnosed. Objective Modern Innovative Solutions in Improving Outcomes in Chronic Obstructive Pulmonary Disease (MISSION COPD) aimed to proactively identify patients from primary care who were undiagnosed or had uncontrolled COPD and to provide a comprehensive integrated multidisciplinary clinic to address the needs of this complex group for improving diagnosis, personalizing therapy, and empowering patients to self-manage their condition. Methods This clinic was led by a respiratory specialist team from Portsmouth Hospitals NHS Trust working with five primary care surgeries in Wessex. A total of 108 patients were reviewed, with 98 patients consenting to provide additional data for research. Diagnoses were changed in 14 patients, and 32 new diagnoses were made. Results Reductions were seen across all aspects of unscheduled care as compared to the prior 12 months, including in emergency general practitioner visits (3.37-0.79 visits per patient, P<.001), exacerbations (2.64-0.56 per patient, P=.01), out-of-hours calls (0.16-0.05 per patient, P=.42), and hospital admissions (0.49-0.12 per patient, P=.48). Improvements were observed in the quality of life and symptom scores in addition to patient activation and patient-reported confidence levels. Conclusions This pilot demonstrates that the MISSION model may be an effective way to provide comprehensive gold-standard care that is valued by patients and to promote integration across sectors.

scholarly journals Modern Innovative Solutions in Improving Outcomes in Chronic Obstructive Pulmonary Disease (MISSION COPD): Mixed Methods Evaluation of a Novel Integrated Care Clinic (Preprint)

2017 ◽  
Author(s):  
Eleanor Lanning ◽  
Jayne Longstaff ◽  
Thomas Jones ◽  
Claire Roberts ◽  
Daniel Neville ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Primary Care ◽  
Pulmonary Disease ◽  
Hospital Admissions ◽  
Patient Activation ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Care Clinic ◽  
Patient Reported ◽  
Innovative Solutions

BACKGROUND Chronic obstructive pulmonary disease (COPD) is the second-leading cause of death in the United Kingdom and accounts for 1.7% of bed days in acute hospitals. An estimated two-third of patients with COPD remain undiagnosed. OBJECTIVE Modern Innovative Solutions in Improving Outcomes in Chronic Obstructive Pulmonary Disease (MISSION COPD) aimed to proactively identify patients from primary care who were undiagnosed or had uncontrolled COPD and to provide a comprehensive integrated multidisciplinary clinic to address the needs of this complex group for improving diagnosis, personalizing therapy, and empowering patients to self-manage their condition. METHODS This clinic was led by a respiratory specialist team from Portsmouth Hospitals NHS Trust working with five primary care surgeries in Wessex. A total of 108 patients were reviewed, with 98 patients consenting to provide additional data for research. Diagnoses were changed in 14 patients, and 32 new diagnoses were made. RESULTS Reductions were seen across all aspects of unscheduled care as compared to the prior 12 months, including in emergency general practitioner visits (3.37-0.79 visits per patient, <italic>P</italic>&lt;.001), exacerbations (2.64-0.56 per patient, <italic>P</italic>=.01), out-of-hours calls (0.16-0.05 per patient, <italic>P</italic>=.42), and hospital admissions (0.49-0.12 per patient, <italic>P</italic>=.48). Improvements were observed in the quality of life and symptom scores in addition to patient activation and patient-reported confidence levels. CONCLUSIONS This pilot demonstrates that the MISSION model may be an effective way to provide comprehensive gold-standard care that is valued by patients and to promote integration across sectors.

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