Abstract
Introduction: 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: To review management opportunities for high-risk COPD patients in Australia, with reference to CONQUEST quality standards (identification, assessment, treatment, and follow-up for high-risk COPD) (https://conquest.care), and national and international guidelines.
Methods: 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.
Results: 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 high-risk 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, ≥90% of smokers had recorded smoking cessation support in each study year. Less than 10% of high-risk patients received a COPD review in each study year (Table 1).
Conclusions: 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.
Aims: To review management opportunities for high-risk COPD patients in Australia, with reference to CONQUEST quality standards (identification, assessment, treatment, and follow-up for high-risk COPD) (https://conquest.care), and national and international guidelines.
Methods: 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.
Results: 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 high-risk 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, ≥90% of smokers had recorded smoking cessation support in each study year. Less than 10% of high-risk patients received a COPD review in each study year (Table 1).
Conclusions: 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 language | English |
|---|---|
| Number of pages | 1 |
| Publication status | Published - 26 Mar 2024 |
| Event | TSANZSRS 2024: The Thoracic Society of Australia and New Zealand and the Australian and New Zealand Society of Respiratory Science - Gold Coast Convention and Exhibition Centre, Gold Coast, Australia Duration: 23 Mar 2024 → 26 Mar 2024 https://tsanzsrsasm.com/ |
Conference
| Conference | TSANZSRS 2024 |
|---|---|
| Abbreviated title | TSANZSRS |
| Country/Territory | Australia |
| City | Gold Coast |
| Period | 23/03/24 → 26/03/24 |
| Internet address |
Bibliographical note
Grant Support: This study was conducted by Optimum Patient Care Australia (OPCA) and was partially funded by AstraZeneca and Optimum Patient Care Australia (OPCA).Acknowledgements: We thank Dominique Novic, Ata Kichkin, Chi Ming Lau, John Pakos, Josephine Samuel-king, Bruce Willet and the Research Working Group for their valuable contribution.
Keywords
- COPD
- Primary Care
- High-risk COPD