BACKGROUND: The introduction of the NICE guideline on COPD and the inclusion of COPD in the new Quality and Outcomes Framework (QOF) were designed to improve the care of people with COPD in primary care in the UK. AIM: We have investigated whether these initiatives have had an impact on the prevalence of COPD, the recording of spirometry data and the use of combined inhaled corticosteroid/long-acting beta-agonist inhalers. DESIGN: We analysed data from The Health Improvement Network for the year before and after the introduction of the NICE guideline. METHODS: Data were analysed using logistic regression. RESULTS: The prevalence of COPD in 2003 was 1.27%, and this increased by 14-1.45% in 2005. The risk of COPD was strongly related to age, male gender, socioeconomic disadvantage and living in the North of England, Scotland and Wales. People with COPD had an increased mortality (adjusted rate ratio for 2003 is 2.38, 95% confidence interval 2.30-2.47). The presence of recorded spirometry data in people with COPD increased from 18% in 2003 to 62% in 2005, and FEV1 was consistently a strong predictor of survival. The use of combination inhalers in people with moderate to severe COPD also increased markedly during the study. CONCLUSION: Following the introduction of the NICE guideline for COPD and the new QOF, there has been an increase in the prevalence of COPD in general practice and a large increase in spirometry data and prescriptions for combination inhalers. This represents significant progress for people with COPD.
BACKGROUND: The introduction of the NICE guideline on COPD and the inclusion of COPD in the new Quality and Outcomes Framework (QOF) were designed to improve the care of people with COPD in primary care in the UK. AIM: We have investigated whether these initiatives have had an impact on the prevalence of COPD, the recording of spirometry data and the use of combined inhaled corticosteroid/long-acting beta-agonist inhalers. DESIGN: We analysed data from The Health Improvement Network for the year before and after the introduction of the NICE guideline. METHODS: Data were analysed using logistic regression. RESULTS: The prevalence of COPD in 2003 was 1.27%, and this increased by 14-1.45% in 2005. The risk of COPD was strongly related to age, male gender, socioeconomic disadvantage and living in the North of England, Scotland and Wales. People with COPD had an increased mortality (adjusted rate ratio for 2003 is 2.38, 95% confidence interval 2.30-2.47). The presence of recorded spirometry data in people with COPD increased from 18% in 2003 to 62% in 2005, and FEV1 was consistently a strong predictor of survival. The use of combination inhalers in people with moderate to severe COPD also increased markedly during the study. CONCLUSION: Following the introduction of the NICE guideline for COPD and the new QOF, there has been an increase in the prevalence of COPD in general practice and a large increase in spirometry data and prescriptions for combination inhalers. This represents significant progress for people with COPD.
Authors: Cecile M A Utens; J A M Maarse; Onno C P van Schayck; Boudewijn L P Maesen; Maureen P M H Rutten; Frank W J M Smeenk Journal: Int J Integr Care Date: 2012-05-18 Impact factor: 5.120
Authors: Barbara P Yawn; Yunfeng Li; Haijun Tian; Jie Zhang; Steve Arcona; Kristijan H Kahler Journal: Int J Chron Obstruct Pulmon Dis Date: 2013-06-27
Authors: Daniel Kotz; Colin R Simpson; Wolfgang Viechtbauer; Onno C P van Schayck; Aziz Sheikh Journal: NPJ Prim Care Respir Med Date: 2014-05-20 Impact factor: 2.871
Authors: Jennifer K Quint; Hana Müllerova; Rachael L DiSantostefano; Harriet Forbes; Susan Eaton; John R Hurst; Kourtney Davis; Liam Smeeth Journal: BMJ Open Date: 2014-07-23 Impact factor: 2.692