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Trends in management and outcomes of COPD patients in primary care, 2000-2009: a retrospective cohort study
File(s)
Author(s)
James, GD
Donaldson, GC
Wedzicha, JA
Nazareth, I
Type
Journal Article
Abstract
Background:Since the introduction of the Quality and Outcomes framework, there has been some evidence of improvement in the management of chronic obstructive pulmonary disease (COPD) patients in the United Kingdom through increasing rates of smoking cessation advice and immunisations against influenza. However, it is unknown whether disease-specific management criteria, disease outcomes and diagnosis have improved.Aims:To describe changes in the management and outcomes of patients with COPD in UK general practice between 2000 and 2009.Methods:The study was done on a retrospective cohort using data from The Health Improvement Network UK primary care database. We calculated age at diagnosis of COPD and death, total number of short-term oral corticosteroid courses and consultations, and proportion of patients with very severe COPD and on triple inhaled therapy for each year between 2000 and 2009.Results:We identified 92,576 patients with COPD. The mean age at COPD diagnosis decreased from 68.1 years in 2000 to 66.7 years in 2009. The mean age at death increased from 78.2 years in 2000 to 78.8 years in 2009. The number of prescribed courses of oral corticosteroids increased from 0.6 in 2000 to 0.8 in 2009. The number of consultations increased from 9.4 in 2004 to 11.3 in 2009. The risk of having very severe COPD decreased from 9.4% in 2004 to 6.8% in 2009. The likelihood of patients with very severe COPD receiving triple therapy increased from 25% in 2004 to 59% in 2009.Conclusions:The trends suggest that management and outcomes observed in patients with COPD may have improved since the year 2000.
Date Issued
2014-07-03
Date Acceptance
2014-03-10
Citation
npj Primary Care Respiratory Medicine, 2014, 24, pp.14015-14015
URI
DOI
ISSN
2055-1010
Publisher
Nature Publishing Group
Start Page
14015
End Page
14015
Journal / Book Title
npj Primary Care Respiratory Medicine
Volume
24
Copyright Statement
© 2014 Primary Care Respiratory Society UK/Macmillan Publishers Limited. This work is licensed under a Creative Commons Attribution 4.0
International License. The images or other third party material in this
article are included in the article
’
s Creative Commons license, unless indicated
otherwise in the credit line; if the material is not included under the Creative
Commons license, users will need to obtain permission from the license holder to
reproduce the material. To view a copy of this license, visit http://creativecommons.org/
licenses/by/4.0/
Identifier
http://www.ncbi.nlm.nih.gov/pubmed/24990313
Subjects
Science & Technology
Life Sciences & Biomedicine
Primary Health Care
Respiratory System
General & Internal Medicine
OBSTRUCTIVE PULMONARY-DISEASE
NETWORK THIN DATABASE
MEDICAL-RECORDS
PREVALENCE
UK
EXACERBATION
FRAMEWORK
QUALITY
INCENTIVES
BURDEN
Adrenal Cortex Hormones
Adult
Aged
Aged, 80 and over
Bronchodilator Agents
Female
Humans
Male
Middle Aged
Patient Outcome Assessment
Practice Patterns, Physicians'
Pulmonary Disease, Chronic Obstructive
Quality of Health Care
Retrospective Studies
United Kingdom
Notes
James, Gareth D Donaldson, Gavin C Wedzicha, Jadwiga A Nazareth, Irwin England NPJ Prim Care Respir Med. 2014 Jul 3;24:14015. doi: 10.1038/npjpcrm.2014.15. Background:Since the introduction of the Quality and Outcomes framework, there has been some evidence of improvement in the management of chronic obstructive pulmonary disease (COPD) patients in the United Kingdom through increasing rates of smoking cessation advice and immunisations against influenza. However, it is unknown whether disease-specific management criteria, disease outcomes and diagnosis have improved.Aims:To describe changes in the management and outcomes of patients with COPD in UK general practice between 2000 and 2009.Methods:The study was done on a retrospective cohort using data from The Health Improvement Network UK primary care database. We calculated age at diagnosis of COPD and death, total number of short-term oral corticosteroid courses and consultations, and proportion of patients with very severe COPD and on triple inhaled therapy for each year between 2000 and 2009.Results:We identified 92,576 patients with COPD. The mean age at COPD diagnosis decreased from 68.1 years in 2000 to 66.7 years in 2009. The mean age at death increased from 78.2 years in 2000 to 78.8 years in 2009. The number of prescribed courses of oral corticosteroids increased from 0.6 in 2000 to 0.8 in 2009. The number of consultations increased from 9.4 in 2004 to 11.3 in 2009. The risk of having very severe COPD decreased from 9.4% in 2004 to 6.8% in 2009. The likelihood of patients with very severe COPD receiving triple therapy increased from 25% in 2004 to 59% in 2009.Conclusions:The trends suggest that management and outcomes observed in patients with COPD may have improved since the year 2000.
Publication Status
Published