Identifying opportunities for optimising the management of high-risk COPD patients in Australia: an observational study

Alexander Evans, Kerry Hancock, Andrew P Dickens, Christine Jenkins, Anita Sharma, Belinda Cochrane, Paul K F Leong, Brian Ko, Florian Heraud, Porsche Le Cheng, Alexander Roussos, Sinthia Bosnic-Anticevich , Fabio Botini, Victoria Carter, Angelina Catanzariti, Clare Ghisla, Thao Le, Chantal E. Le Lievre, Ruth B Murray, Kanchanamala RanasingheDeb Stewart, Marije van Melle, Rebecca Vella, Russell Wiseman, David Price

Research output: Contribution to conferenceAbstractpeer-review


Prior exacerbation history and current management opportunities are associated with future exacerbation risk. UK and US studies undertaken as part of the CONQUEST program have identified opportunities to optimise COPD management. It is unknown the extent of similar opportunities in other healthcare systems, such as Australia.
Aims and objectives
To review management opportunities for high-risk COPD patients in Australia, with reference to national and international guidelines, and CONQUEST quality standards1 (identification, assessment, treatment and follow-up for high-risk COPD).
We utilised the Optimum Patient Care Research Database Australia (OPCRDA), a primary care database of electronic health record (EHR) data containing 900,000 ever-active patients, to identify patients with a COPD diagnosis at high-risk of future exacerbations (≥2 exacerbations in the previous 12 months, based on clinical data and prescribed antibiotics or oral corticosteroids). EHR coded and
free text data were analysed to examine COPD maintenance therapy, smoking cessation support and formal COPD reviews (defined as a recorded COPD review/advice/education or lung function assessment). Cross-sectional analyses were conducted on annual patient cohorts between 2015-2019 to exclude confounding by COVID-19.
The proportion of diagnosed COPD patients defined as high-risk ranged from 30.3% (1620/5340) in 2016 to 24.9% (1476/5992) in 2019 (Table 1). Across the 5-year period, approximately 40% of highrisk patients were not prescribed any COPD maintenance therapy, while the most common therapies were LABA/ICS (~18%) and LAMA/LABA/ICS (~25%). In this population, the proportion of smokers with recorded smoking cessation support reduced from 36% in 2015 to 30% in 2019. Less than 20% of highrisk patients received a COPD review in each study year (Table 1).
There is substantial opportunity to improve the assessment and treatment of patients with diagnosed COPD by reviewing and managing high-risk patients systematically in line with guidelines and CONQUEST quality standards
Original languageEnglish
Number of pages1
Publication statusPublished - 1 Sept 2023
Event8th REG Summit - Lisbon Marriott , Lisbon, Portugal
Duration: 16 Mar 202318 Mar 2023


Conference8th REG Summit
Internet address


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