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

doi:10.1038/s41533-021-00219-x

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^* (Corresponding Author)

^*Corresponding author for this work

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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 1,602 at-risk patients from 12 practices who were invited to attend the clinic. 383(23.9%) responded and 288 were enrolled into the study. 48(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 language	English
Article number	7
Number of pages	8
Journal	npj Primary Care Respiratory Medicine
Volume	31
DOIs	https://doi.org/10.1038/s41533-021-00219-x
Publication status	Published - 11 Feb 2021

Bibliographical note

Acknowledgments
This report is independent research funded by the National Institute for Health Research Wessex ARC. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care. We are very grateful to Optimum Patient care and their team for their help and support with the data extraction and application of the case-finding risk score. We would also like to thank: The participants, Mark Stafford-Watson (PPI) in memorial, Colin Newell, Dr Fiona McKenna, Dr Andy Powell, Dr Helen Myers, Dr Stuart McKinnes, Dr Mark Williams, Dr Louisa Egbe, Dr Richard Baxter, Dr Sarah A’Court, Dr Elisabeth Willows, Dr Gareth Morris, Dr Ford, Dr Kate Lippiett, Wessex Clinical Research Network, West Hampshire CCG and Southampton City CCG

Keywords

Chronic obstructive pulmonary disease
Health Care
Medical research
Respiratory signs and symptons

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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Cite this

Ray, E., Culliford, D., Kruk, H., Gillett, K., North, M., Astles, C. M., Hicks, A., Johnson, M., Lin, S. X., Orlando, R., Thomas, M., Jordan, R. E., Price, D., Konstantin, M., & Wilkinson, T. M. A. (2021). Specialist Respiratory Outreach: a case-finding initiative for identifying undiagnosed COPD in primary care . npj Primary Care Respiratory Medicine, 31, Article 7. https://doi.org/10.1038/s41533-021-00219-x

Ray, E, Culliford, D, Kruk, H, Gillett, K, North, M, Astles, CM, Hicks, A, Johnson, M, Lin, SX, Orlando, R, Thomas, M, Jordan, RE, Price, D, Konstantin, M & Wilkinson, TMA 2021, 'Specialist Respiratory Outreach: a case-finding initiative for identifying undiagnosed COPD in primary care ', npj Primary Care Respiratory Medicine, vol. 31, 7. https://doi.org/10.1038/s41533-021-00219-x

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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 1,602 at-risk patients from 12 practices who were invited to attend the clinic. 383(23.9%) responded and 288 were enrolled into the study. 48(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. ",

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note = "Acknowledgments This report is independent research funded by the National Institute for Health Research Wessex ARC. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care. We are very grateful to Optimum Patient care and their team for their help and support with the data extraction and application of the case-finding risk score. We would also like to thank: The participants, Mark Stafford-Watson (PPI) in memorial, Colin Newell, Dr Fiona McKenna, Dr Andy Powell, Dr Helen Myers, Dr Stuart McKinnes, Dr Mark Williams, Dr Louisa Egbe, Dr Richard Baxter, Dr Sarah A{\textquoteright}Court, Dr Elisabeth Willows, Dr Gareth Morris, Dr Ford, Dr Kate Lippiett, Wessex Clinical Research Network, West Hampshire CCG and Southampton City CCG",

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AU - Astles, Carla M

AU - Hicks, Alexander

AU - Johnson, Matthew

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AU - Price, David

AU - Konstantin, Mita

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N1 - Acknowledgments This report is independent research funded by the National Institute for Health Research Wessex ARC. The views expressed in this publication are those of the author(s) and not necessarily those of the National Institute for Health Research or the Department of Health and Social Care. We are very grateful to Optimum Patient care and their team for their help and support with the data extraction and application of the case-finding risk score. We would also like to thank: The participants, Mark Stafford-Watson (PPI) in memorial, Colin Newell, Dr Fiona McKenna, Dr Andy Powell, Dr Helen Myers, Dr Stuart McKinnes, Dr Mark Williams, Dr Louisa Egbe, Dr Richard Baxter, Dr Sarah A’Court, Dr Elisabeth Willows, Dr Gareth Morris, Dr Ford, Dr Kate Lippiett, Wessex Clinical Research Network, West Hampshire CCG and Southampton City CCG

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N2 - 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 1,602 at-risk patients from 12 practices who were invited to attend the clinic. 383(23.9%) responded and 288 were enrolled into the study. 48(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.

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Specialist Respiratory Outreach: a case-finding initiative for identifying undiagnosed COPD in primary care

Abstract

Bibliographical note

Keywords

UN SDGs

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