Practice Patterns in the Management of Chronic Obstructive Pulmonary Disease in Primary Practice: The Cage Study

Bourbeau, Jean; Sebaldt, Rolf J.; Day, Anna; Bouchard, Jacques; Kaplan, Alan; Hernández, Paul; Rouleau, Michel; Petrie, Annie; Foster, Gary; Thabane, Lehana; Haddon, Jennifer; Scalera, Alissa

doi:10.1155/2008/173904

Cited by 146 publications

(142 citation statements)

References 15 publications

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“…Our data also indicate that only a minority of COPD patients in primary care are offered pulmonary rehabilitation advice or a referral for pulmonary rehabilitation, in line with data from other countries (13). The remarkably low documentation of self-management support and exacerbation-management or instruction with a written action plan is striking.…”

Section: Interpretation Of Findings In Relation To Previously Publishsupporting

confidence: 83%

“…The documented counselling rate in the present study is much better than the 50% reported from former Swiss primary care data and is more in line with international benchmarks (8,13).…”

Section: Interpretation Of Findings In Relation To Previously Publishsupporting

confidence: 72%

“…Guidelines address management of stable COPD as well as exacerbations and give recommendations for evidence based care (5,12). However, variations in treatment and non-adherence to recommendations have a negative impact on the quality of care (8,(13)(14)(15). The Institute of Medicine (IOM) quality report emphasizes the need for better assessment of care quality by measuring performance (16).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Performance Measures in the Management of Chronic Obstructive Pulmonary Disease in Primary Care – A Retrospective Analysis

Kaufmann

Markun

Hasler

et al. 2015

Praxis

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Leistungsmessgrössen in der Grundversorgung von Patienten mit COPD – eine Analyse Zusammenfassung. Hintergrund: Das Befolgen der Empfehlungen für ein gutes Management der chronisch-obstruktiven Lungenkrankheit (COPD) verbessert wichtige Endpunkte. Leistungsmessgrössen (LM) reflektieren die Qualität der Betreuung, dennoch existieren über die Dokumentation dieser Messgrössen bei COPD für die Grundversorgung kaum Daten. Ziel: Überprüfen der Dokumentation von COPD spezifischen Messgrössen in Grundversorgerpraxen des Kanton Zürich. Methode: Retrospektive Auswertung der Krankengeschichten von Patienten mit ärztlich diagnostizierter COPD, über einen Zeitraum von zwölf Monaten. Die Dokumentation der LM wurde durch Berechnen des Prozentsatzes der dokumentierten Parameter bewertet. Zusätzlich erfolgte ein Vergleich der LM Dokumentation mit einer Praxis, die ein strukturiertes COPD-Programm implementiert hatte. Resultate: Es wurden Daten von 115 Patienten aus 14 Praxen, davon 57% männlich, mit einem Durchschnittsalter von 68 (44–93) Jahren, analysiert. 46% waren aktive Raucher mit 56 (22–150 py) Packyears. Komorbiditäten waren in 73% der Fälle dokumentiert, der Schweregrad mit GOLD-Klassifizierung in 70% (GOLD I 11%, GOLD II 64%, GOLD III 21%, GOLD IV 4%).Gemäss Dokumentation hatten die Patienten durchschnittlich 1,4 Exazerbationen pro Jahr. Die Dokumentation der LM lag zwischen 16% (schriftlicher Aktionsplan im Falle von Exazerbationen) und 95% (Raucherstatus). Eine Dokumentation für eine Rauchstopp-Empfehlung fand sich in 74% der Fälle, für die Grippeimpfung in 49%. Eine adäquate medikamentöse Therapie und Instruktion der Inhalation war für 65 bzw. 57%, für pulmonale Rehabilitation in 27% der Patienten dokumentiert. Angaben zu einer kollaborativen und proaktiven Betreuung fanden sich bei 60 resp. 51%. Die Praxis mit dem laufenden COPD-Programm zeigte eine signifikant bessere Dokumentation (p<0,01) für alle LM ausser für die Grippeimpfung. Schlussfolgerung: In der Schweizer Grundversorgung bestehen Lücken in der Dokumentation hinsichtlich der Empfehlungen für eine nutzbringende COPD-Versorgung. Die Identifikation und Überbrückung dieser Lücken ist zentral für mehr Qualität in der Gesundheitsversorgung.

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Section: Interpretation Of Findings In Relation To Previously Publishsupporting

confidence: 83%

“…The documented counselling rate in the present study is much better than the 50% reported from former Swiss primary care data and is more in line with international benchmarks (8,13).…”

Section: Interpretation Of Findings In Relation To Previously Publishsupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Performance Measures in the Management of Chronic Obstructive Pulmonary Disease in Primary Care – A Retrospective Analysis

Kaufmann

Markun

Hasler

et al. 2015

Praxis

View full text Add to dashboard Cite

show abstract

“…However, the age, sex, and severity of COPD (according to the GOLD stage) of those patients who were included are comparable with the same characteristics of primary care patients with COPD who have participated in other studies. 22,23 To the authors' knowledge, this is the first study analysing changes in experienced personal and team continuity after the introduction of new care modes.…”

Section: Strengths and Limitationsmentioning

confidence: 98%

Continuity in different care modes and its relationship to quality of life: a randomised controlled trial in patients with COPD

Uijen¹,

Bischoff²,

Schellevis³

et al. 2012

Br J Gen Pract

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“…Unfortunately, spirometry is significantly underutilized in primary care, with estimations of only about 50% to 60% of patients having had a single spirometry in the management of their asthma 1 or COPD. 2,3 Although the words are often used interchangeably, it is important to note that there is a difference between spirometry and pulmonary function testing (PFT). Spirometry is a diagnostic tool that can be performed anywhere by a properly trained health care professional.…”

Section: Introductionmentioning

confidence: 99%

The role of spirometry in the management of obstructive airways disease: How pharmacists should get involved

Kaplan¹,

Levitz²,

Petrasko³

2017

Can Pharm J

Self Cite

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Practice Patterns in the Management of Chronic Obstructive Pulmonary Disease in Primary Practice: The Cage Study

Abstract: Substantial gaps between recommended and current care exist in the management of COPD patients in primary care practice. Undertreatment of patients with severe COPD has potential clinical implications, including loss of autonomy and hospitalization.

Cited by 146 publications

References 15 publications

Performance Measures in the Management of Chronic Obstructive Pulmonary Disease in Primary Care – A Retrospective Analysis

Performance Measures in the Management of Chronic Obstructive Pulmonary Disease in Primary Care – A Retrospective Analysis

Continuity in different care modes and its relationship to quality of life: a randomised controlled trial in patients with COPD

The role of spirometry in the management of obstructive airways disease: How pharmacists should get involved

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