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Trends in management and outcomes of COPD patients in primary care, 2000-2009: a retrospective cohort study.

James GD, Donaldson GC, Wedzicha JA, Nazareth I - NPJ Prim Care Respir Med (2014)

Bottom Line: However, it is unknown whether disease-specific management criteria, disease outcomes and diagnosis have improved.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.

View Article: PubMed Central - PubMed

Affiliation: 1] Department of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Hampstead, London, UK [2] Centre for Respiratory Medicine, University College London, Royal Free Campus, Hampstead, London, UK.

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.

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Prevalence and incidence rates of chronic obstructive pulmonary disease between 2000 and 2009.
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fig1: Prevalence and incidence rates of chronic obstructive pulmonary disease between 2000 and 2009.

Mentions: In total, there were 2,839,694 patients in 419 general practices who were aged between 35 and 89 years between 2000 and 2009; 92,576 (3%) had a clinical record of COPD. The average follow-up time from COPD diagnosis was 3 years and 10 months. The mean age of prevalent COPD patients was 71 years, and 54% of patients were male. In comparison with the general population, patients with COPD were older and from more socially deprived areas (Table 1). The recorded prevalence of COPD increased from 24 individuals per 1,000 patient-years in 2000 to 36 in 2009, equivalent to a 50% increase over the 10-year period (Figure 1). However, the diagnosis of new COPD cases remained fairly constant at 3.5 individuals per 1,000 patient-years.


Trends in management and outcomes of COPD patients in primary care, 2000-2009: a retrospective cohort study.

James GD, Donaldson GC, Wedzicha JA, Nazareth I - NPJ Prim Care Respir Med (2014)

Prevalence and incidence rates of chronic obstructive pulmonary disease between 2000 and 2009.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4373314&req=5

fig1: Prevalence and incidence rates of chronic obstructive pulmonary disease between 2000 and 2009.
Mentions: In total, there were 2,839,694 patients in 419 general practices who were aged between 35 and 89 years between 2000 and 2009; 92,576 (3%) had a clinical record of COPD. The average follow-up time from COPD diagnosis was 3 years and 10 months. The mean age of prevalent COPD patients was 71 years, and 54% of patients were male. In comparison with the general population, patients with COPD were older and from more socially deprived areas (Table 1). The recorded prevalence of COPD increased from 24 individuals per 1,000 patient-years in 2000 to 36 in 2009, equivalent to a 50% increase over the 10-year period (Figure 1). However, the diagnosis of new COPD cases remained fairly constant at 3.5 individuals per 1,000 patient-years.

Bottom Line: However, it is unknown whether disease-specific management criteria, disease outcomes and diagnosis have improved.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.

View Article: PubMed Central - PubMed

Affiliation: 1] Department of Primary Care & Population Health, UCL Medical School, Royal Free Campus, Hampstead, London, UK [2] Centre for Respiratory Medicine, University College London, Royal Free Campus, Hampstead, London, UK.

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.

Show MeSH
Related in: MedlinePlus