Accuracy of diagnostic registers and management of chronic obstructive pulmonary disease: the Devon primary care audit.

Respiratory Research
Rupert JonesBryanie S Shackell

Abstract

Guidelines on COPD diagnosis and management encourage primary care physicians to detect the disease at an early stage and to treat patients according to their condition and needs. Problems in guideline implementation include difficulties in diagnosis, using spirometry and the disputed role of reversibility testing. These lead to inaccurate diagnostic registers and inadequacy of administered treatments. This study represents an audit of COPD diagnosis and management in primary care practices in Devon. Six hundred and thirty two patients on COPD registers in primary care practices were seen by a visiting Respiratory Specialist Nurse. Diagnoses were made according to the NICE guidelines. Reversibility testing was carried out either routinely or based on clinical indication in two sub-samples. Dyspnoea was assessed. Data were entered into a novel IT-based software which computed guideline-based treatment recommendations. Current and recommended treatments were compared. Five hundred and eighty patients had spirometry. Diagnoses of COPD were confirmed in 422 patients (73%). Thirty nine patients were identified as asthma only, 94 had normal spirometry, 23 were restrictive and 2 had a cardiac disorder. Reversibility testing changed di...Continue Reading

References

Jun 25, 1977·British Medical Journal·C Fletcher, R Peto
May 30, 2003·Health and Quality of Life Outcomes·Thys van der MolenElizabeth F Juniper
Jun 29, 2004·The European Respiratory Journal·B R CelliUNKNOWN ATS/ERS Task Force
Oct 16, 2004·Respiratory Medicine·Olivier T RutschmannFrançois P Sarasin
Dec 27, 2005·Drug and Therapeutics Bulletin
Feb 24, 2006·Proceedings of the American Thoracic Society·Bartolome R Celli
Apr 14, 2006·The European Respiratory Journal·R J HalbertD M Mannino
May 17, 2006·Primary Care Respiratory Journal : Journal of the General Practice Airways Group·Aye Ma Lwin, Robert K McKinley
Aug 3, 2006·Journal of Clinical Pharmacy and Therapeutics·V TsagarakiA Amfilochiou
Feb 23, 2007·The New England Journal of Medicine·Peter M A CalverleyUNKNOWN TORCH investigators
Sep 18, 2013·COPD·Konstantinos KostikasPetros Bakakos
Dec 1, 2001·Primary Care Respiratory Journal : Journal of the General Practice Airways Group·Rupert C M JonesFrank Dobbs

❮ Previous
Next ❯

Citations

May 23, 2013·International Journal for Quality in Health Care : Journal of the International Society for Quality in Health Care·Nancy Dixon
Oct 3, 2009·American Journal of Respiratory and Critical Care Medicine·Rupert C JonesMichael E Hyland
Jul 8, 2010·BMC Geriatrics·Jen-Tzer GauTzu-Cheg Kao
Feb 2, 2013·Clinical and Translational Medicine·Xiaocong FangChunxue Bai
Feb 12, 2011·International Journal of Chronic Obstructive Pulmonary Disease·Richard RussellIdelle Weisman
May 9, 2012·International Journal of Chronic Obstructive Pulmonary Disease·Zaurbek AisanovGrant Waterer
Dec 19, 2013·International Journal of Chronic Obstructive Pulmonary Disease·Christian GhattasMagdi H Awad
May 2, 2012·The British Journal of General Practice : the Journal of the Royal College of General Practitioners·Mohammed Saqib AnwarM John Bankart
Sep 12, 2014·International Journal of Chronic Obstructive Pulmonary Disease·David PriceKatsiaryna Bichel
May 8, 2014·International Journal of Family Medicine·Nathalie SaadJean Bourbeau
Mar 7, 2014·Thorax·Simon E BrillJadwiga A Wedzicha
May 14, 2010·International Journal of Chronic Obstructive Pulmonary Disease·Charlotte Suppli UlrikUNKNOWN KVASIMODO II study group
Jan 24, 2014·Current Medical Research and Opinion·S MaioUNKNOWN COMODHES study group
Jan 31, 2012·Revista de calidad asistencial : organo de la Sociedad Española de Calidad Asistencial·G J Díaz-GrávalosI Casado-Górriz
Dec 3, 2010·Mayo Clinic Proceedings·David B PriceRupert C M Jones
Dec 24, 2008·Respiratory Medicine·Mario CazzolaClaudio Cricelli
Nov 8, 2012·Primary Care Respiratory Journal : Journal of the General Practice Airways Group·Robert M AngusMike G Pearson
Apr 22, 2011·Primary Care Respiratory Journal : Journal of the General Practice Airways Group·Mario CazzolaPaola Rogliani
Jun 21, 2011·Primary Care Respiratory Journal : Journal of the General Practice Airways Group·Julia A WaltersRichard Wood-Baker
Jun 12, 2012·Respiratory Medicine·Annelies E LucasOnno P van Schayck
Nov 4, 2016·NPJ Primary Care Respiratory Medicine·David PriceDaniel West
Jun 27, 2013·Journal of Primary Care & Community Health·Rafael Laniado-LaborínOtto Bauerle
Mar 27, 2015·NPJ Primary Care Respiratory Medicine·C Michael RobertsJames Mountford
Jul 17, 2014·Jornal brasileiro de pneumologia : publicaça̋o oficial da Sociedade Brasileira de Pneumologia e Tisilogia·Irai Luis GiacomelliMariângela Pimentel Pincelli
May 5, 2017·European Clinical Respiratory Journal·Dermot RyanUNKNOWN Respiratory Effectiveness Group
Dec 14, 2012·The Cochrane Database of Systematic Reviews·Daniela J VollenweiderMilo A Puhan
Sep 28, 2015·The Cochrane Database of Systematic Reviews·Emma J Welsh, Robin Carr
Jun 2, 2018·The European Respiratory Journal·Joan B SorianoUNKNOWN Respiratory Effectiveness Group
Jun 17, 2015·Critical Care Medicine·Davide ColomboGianmaria Cammarota
Oct 11, 2017·Current Opinion in Pulmonary Medicine·Manuel Suarez-BarceloGary T Ferguson
Oct 30, 2018·The Cochrane Database of Systematic Reviews·Daniela J VollenweiderMilo A Puhan
Dec 7, 2017·COPD·S ZewariY Heijdra
Nov 9, 2017·COPD·Marco ContoliNicola Scichilone
Sep 24, 2010·Postgraduate Medicine·Len FromerBarbara Yawn

❮ Previous
Next ❯

Software Mentioned

Patient Centred Software
SPSS

Related Concepts

Related Feeds

Bacterial Pneumonia (ASM)

Bacterial pneumonia is a prevalent and costly infection that is a significant cause of morbidity and mortality in patients of all ages. Here is the latest research.

Bacterial Pneumonia

Bacterial pneumonia is a prevalent and costly infection that is a significant cause of morbidity and mortality in patients of all ages. Here is the latest research.

CFTR Mutant Structural Therapy

Over 1700 different mutations in the CFTR genes have been shown to cause cystic fibrosis. Here is the latest research on structural therapy for CFTR mutants.