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Chronic obstructive pulmonary disease: organisation of care

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JA Roberts. Salford PCT, Salford, UK

Background: Our integrated chronic obstructive pulmonary disease (COPD) team works closely with general practice to improve COPD care in a primary care trust (PCT) with high levels of social deprivation and COPD. Integral to our approach is the general practice COPD register that uses a standardised template to structure consultations in line with national guidelines. De-identified data are collected remotely at 3-month intervals.

Aims: To compare data from baseline with those available at 12 months. To establish general practice adherence to guideline recommendations on COPD follow-up and management.

Methods: We retrospectively analysed data from the COPD register at 12 months and compared with baseline COPD prevalence, FEV1 percentage predicted, MRC score, smoking status and current medication.

Results: 12-month data were available from 25 of 56 practices (55% of the total population and 56% of the COPD population). Recorded diagnosis of COPD n  =  3291 (n  =  2888 baseline). Mean prevalence 2.4% (range 1.3–4.5%; 2.1% baseline). 53% female. Mean age 68.7 years (range 30–97). Smoking status at 12 months (baseline), never smoked 12% (12%), ex-smoker 48% (46%), current smoker 40% (42%). 48% of patients (n  =  1574) had a read code for COPD review in the last 12 months (range 0–83%). 54% (n  =  1781) of patients had undergone spirometry in the last 12 months. Severity of COPD could not be ascertained from 51 of these readings. 12% had FEV1 greater than 80% (10% baseline), 53% mild COPD (44% baseline), 27% moderate COPD (30.5% baseline), 8% severe COPD (10% baseline) according to NICE guidelines (2004). MRC score was recorded on 48% of patients (27% at baseline). The table highlights the proportion of patients receiving drug treatment category according to severity for total COPD population at 12 months (baseline).

Conclusions: In the 12 months …

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