An evidence-based quality improvement perspective for a chronic obstructive pulmonary disease case-finding program

Estes, Tracy S.; Short, Nancy; Bowser, Donna M.; Boyle, Anne

doi:10.1177/1479972314538979

Cited by 3 publications

(9 citation statements)

References 13 publications

(17 reference statements)

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“…Other evidence suggests that rising rates of COPD in women are likely to be a result of women's greater inclination to seek medical advice (Malmusi et al, 2014) and to partake in screening (Menezes et al, 2005;Estes et al, 2014;Weiss et al, 2014;Delgado et al, 2016;Kotaki et al, 2017). Traditional gender roles saw men as the 'stronger' character.…”

Section: Resultsmentioning

confidence: 99%

“…Others support case-finding only, where patients are screened for COPD based on symptoms and risk factors (Buist et al, 2005;Estes et al, 2014;Weiss et al, 2014;López Varela et al, 2016;GOLD, 2017). NICE (2011) argue that case-finding is the most cost-effective method.…”

Section: The Obligation Of Screening For Early Diagnosismentioning

confidence: 99%

“…Moreover, generalised screening generates a vast increase in workload that professionals may be unable to handle (Haroon et al, 2015). Staff and funding are often barriers to screening in primary care (Estes et al, 2014;Kotaki et al, 2017). To investigate the prevalence of COPD, characterised by airflow obstruction in spirometry in a group of asymptomatic smokers (5 or more years) with no history of asthma, COPD or respiratory symptoms; and to identify risk factors of abnormal spirometry…”

Section: The Obligation Of Screening For Early Diagnosismentioning

confidence: 99%

“…Confusion exists among the tools utilised. The recommended screening methods for COPD include the use of medical examinations with questionnaires (Estes et al, 2014;López Varela, 2016;Siu et al, 2016) to identify relevant risk factors, followed by diagnostic spirometry (Menezes et al, 2005;Levy et al, 2006;Buist et al, 2005;Weiss et al, 2014;Celli et al, 2015;Delgado et al, 2016;López Varela et al, 2016;Roberts et al, 2016;GOLD, 2017;Kotaki et al, 2017). Microspirometry with questionnaires may also be utilised as a precursor method for spirometry, as both are accessible in primary care settings, without the necessity for spirometers (Celli et al, 2015); and are affordable (Sichletidis et al, 2011;Dirven et al, 2013).…”

Section: Confusion Regarding Diagnostic Toolsmentioning

confidence: 99%

“…In addition to precursor tools, nurses must perform history taking and physical assessment prior to diagnostic testing (Celli et al, 2015;Roberts et al, 2016;Bragadottir et al, 2017;GOLD, 2017). Studies were found incorrectly using hand-held microspirometry to confirm COPD diagnosis (Estes et al, 2014). This is not advised in practice, as microspirometers often cause an over-estimation of COPD prevalence, and are consequently employed as an accurate, sensitive precursor tool, not a diagnostic tool (Frith et al, 2011).…”

Section: Confusion Regarding Diagnostic Toolsmentioning

confidence: 99%

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What factors influence an early COPD diagnosis in primary care?

Mercy

Fotis

2018

Practice Nursing

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This systematic literature review aimed to identify factors influencing late- and under-diagnosis of COPD in primary care Background: There are millions of people living with chronic obstructive pulmonary disease (COPD) who have not been diagnosed. Patients have regularly lost half of their lung function by the point of diagnosis, and therefore there are fewer interventions available. Aim: The aim of this systematic literature review was to identify factors influencing late- and under-diagnosis of COPD in primary care. This includes considering the current methods of COPD screening, and whether early screening would benefit diagnostic rates. Methods: A comprehensive, systematic literature search was undertaken using the following databases: BNI, CINAHL, Medline, NHS Evidence, PubMed, ScienceDirect, Wiley Online. Following this, a critical review of the literature was performed on 10 relevant articles. A thematic analysis followed. Results: There is a significant lack of up-to-date research on COPD screening and early detection. Generalised screening versus case-finding may be a method of identifying the undiagnosed population; however, evidence needs to improve. There is a lack of COPD education in healthcare and wider society. COPD among women is on the rise, yet they are less likely to be identified. There is a necessity for guidance and research to be provided. Screening is likely to be the future preferred method for identifying those undiagnosed, but research needs to identify the benefits of screening versus casefinding. Conclusion: The findings can be applied to primary care nursing, to combat COPD under-diagnosis.

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Section: Resultsmentioning

confidence: 99%

Section: The Obligation Of Screening For Early Diagnosismentioning

confidence: 99%

Section: The Obligation Of Screening For Early Diagnosismentioning

confidence: 99%

Section: Confusion Regarding Diagnostic Toolsmentioning

confidence: 99%

Section: Confusion Regarding Diagnostic Toolsmentioning

confidence: 99%

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What factors influence an early COPD diagnosis in primary care?

Mercy

Fotis

2018

Practice Nursing

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Identifying Patients with Undiagnosed COPD in Primary Care Settings: Insight from Screening Tools and Epidemiologic Studies

et al. 2014

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Objective Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality, yet research suggests this disease is greatly underdiagnosed. This literature review sought to summarize the most common and significant variables associated with case-finding or missed cases of COPD to inform more effective and efficient detection of high-risk COPD patients in primary care. Methods PubMed and EMBASE were searched for articles describing case-finding and epidemiologic research to detect or characterize new cases of COPD. International studies in primary and non-primary care settings, published in English from 2002–2014, were eligible for inclusion. Studies related to risk factors for development of COPD were excluded. Results Of the 33 studies identified and reviewed, 21 were case-finding or screening and 12 were epidemiological, including cross-sectional, longitudinal, and retrospective designs. A range of variables were identified within and across studies. Variables common to both screening and epidemiological studies included age, smoking status, and respiratory symptoms. Seven significant predictors from epidemiologic studies did not appear in screening tools. No studies targeted discovery of higher risk patients such as those with reduced lung function or risks for exacerbations. Conclusion Variables used to identify new cases of COPD or differentiate COPD cases and non-cases are wide- ranging, (from sociodemographic to self-reported health or health history variables), providing insight into important factors for case identification. Further research is underway to develop and test the best, smallest variable set that can be used as a screening tool to identify people with undiagnosed, high-risk COPD in primary care.

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Characterization of Patients with COPD Admitted in Pulmonary Rehabilitation Center.

Neto¹,

Marques²,

Gomes³

2014

mtprehabjournal

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Introduction: COPD is a major cause of morbidity and mortality, which is preventable, thus studies that discusses the characterization of a given population are important for investment in treatments and prevention. Objective: Characterize individuals with Chronic Obstructive Pulmonary Disease, admitted to a pulmonary rehabilitation center. Method: Retrospective study, exploratory character of medical records of patients with COPD. Sample consisted of 37 patients diagnosed with COPD and age greater than 20 years. The following variables were analyzed: sex, age, marital status, occupation, diagnosis, main complaint, and cardiovascular risk factors presented by patients during admission. Results: Individuals aged >40 years and history of smoking have a higher prevalence in developing COPD. Pulmonary emphysema is a major pathological condition. The most common main complaint was dyspnea and cardiovascular risk factor was present sedentary lifestyle. Moreover, women with COPD were more likely to have depression than men. Conclusion: This study enabled the characterization of COPD patients, providing the possibility of investing in prevention and treatment.

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An evidence-based quality improvement perspective for a chronic obstructive pulmonary disease case-finding program

Cited by 3 publications

References 13 publications

What factors influence an early COPD diagnosis in primary care?

What factors influence an early COPD diagnosis in primary care?

Identifying Patients with Undiagnosed COPD in Primary Care Settings: Insight from Screening Tools and Epidemiologic Studies

Characterization of Patients with COPD Admitted in Pulmonary Rehabilitation Center.

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