A snapshot of chronic obstructive pulmonary disease management in general practice in Ireland

05 Aug 2021
Respiratory conditions
  • COPD
Type of resource
Dublin 2021
Raymond O'Connor, University of Limerick Graduate Entry Medical School, Ireland
Clinical Research Results Implementation Science/Service Development Research Ideas on Respiratory Conditions and Tobacco Dependency Abstract Protocol for study of the diagnosis and management of COPD in family practice in Ireland Research QuestionUsing GOLD guidelines 2019 as an audit standard, we will ask: 1. Has the diagnosis been made and coded appropriately? 2. Has the patient’s stage of COPD been formally calculated? 3. Are the patients on appropriate therapy? 4. Have they been offered smoking cessation advice and appropriate vaccination?BackgroundChronic Obstructive Pulmonary Disease (COPD) is currently the fourth leading cause of death in the world, and is a major cause of chronic morbidity. The Global Initiative for Chronic Obstructive Lung Disease (GOLD) has developed detailed diagnosis and management guidelines.Despite this and the availability of effective, well-tolerated treatments, COPD remains substantially under-diagnosed and under-treated within primary care. Chronic disease management in unresourced general practice is often sub-optimal.Possible MethodologyCross sectional study. Nine registrars in family practice will search their practice’s patient management system for files with appropriate codes, disease labels, terms that may be unique to the particular practice, and treatments that indicate a diagnosis of COPD. A random selection of 50 patients will be made per practice. Each patient’s file will then be individually examined to confirm diagnosis and standard of care using a specifically designed data extraction tool. No outside funding.Questions to discussHow effective is this method of case finding in the absence of universal disease coding?What is the percentage of patients whose management is consistent with GOLD guidelines using the criteria outlined?What is the potential of this audit for improving the standard of COPD management in Irish family practice?How appropriate are the current COPD guidelines in clinical practice? Declaration of Interest We have no source of funding and no conflict of interest. Our study has not been registered.Research ethics approval has been granted by the Research Ethics Committee of the Irish College of General Practitioners References and Clinical Trial Registry Information 1. GOLD 2019. Pocket Guide to COPD Diagnosis, Management and Prevention. A Guide for Healthcare Professionalshttps://goldcopd.org/wp-content/uploads/2018/11/GOLD-2019-POCKET-GUIDE-FINAL_WMS.pdf