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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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Related in: MedlinePlus

Management and outcome indices in chronic obstructive pulmonary disease (COPD): 2000–2009. (a) Mean age of prevalent COPD cases, at COPD diagnosis and at death. (b) Proportion of patients in each COPD severity category. (c) Proportion of COPD patients who received triple therapy. (d) Number of oral corticosteroid prescriptions per COPD patient-year. (e) Number of COPD consultations per patient-year.
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fig2: Management and outcome indices in chronic obstructive pulmonary disease (COPD): 2000–2009. (a) Mean age of prevalent COPD cases, at COPD diagnosis and at death. (b) Proportion of patients in each COPD severity category. (c) Proportion of COPD patients who received triple therapy. (d) Number of oral corticosteroid prescriptions per COPD patient-year. (e) Number of COPD consultations per patient-year.

Mentions: The mean age at which COPD was diagnosed decreased from 68.1 years (95% CI, 67.8, 68.4) in 2000 to 66.7 years in 2009 (66.4, 67.0; Table 2 and Figure 2a). The mean age at death of COPD patients increased from 78.2 years (77.9, 78.6) in 2000 to 78.8 years (78.6, 79.1) in 2009. Similarly, the mean age at death of all patients increased from 79.5 years (79.3, 79.6) in 2000 to 80 years (79.9, 80.1) in 2009. Consequently, the mean age of prevalent COPD patients remained fairly constant over the period, varying between 70 and 70.7 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)

Management and outcome indices in chronic obstructive pulmonary disease (COPD): 2000–2009. (a) Mean age of prevalent COPD cases, at COPD diagnosis and at death. (b) Proportion of patients in each COPD severity category. (c) Proportion of COPD patients who received triple therapy. (d) Number of oral corticosteroid prescriptions per COPD patient-year. (e) Number of COPD consultations per patient-year.
© Copyright Policy - open-access
Related In: Results  -  Collection

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

fig2: Management and outcome indices in chronic obstructive pulmonary disease (COPD): 2000–2009. (a) Mean age of prevalent COPD cases, at COPD diagnosis and at death. (b) Proportion of patients in each COPD severity category. (c) Proportion of COPD patients who received triple therapy. (d) Number of oral corticosteroid prescriptions per COPD patient-year. (e) Number of COPD consultations per patient-year.
Mentions: The mean age at which COPD was diagnosed decreased from 68.1 years (95% CI, 67.8, 68.4) in 2000 to 66.7 years in 2009 (66.4, 67.0; Table 2 and Figure 2a). The mean age at death of COPD patients increased from 78.2 years (77.9, 78.6) in 2000 to 78.8 years (78.6, 79.1) in 2009. Similarly, the mean age at death of all patients increased from 79.5 years (79.3, 79.6) in 2000 to 80 years (79.9, 80.1) in 2009. Consequently, the mean age of prevalent COPD patients remained fairly constant over the period, varying between 70 and 70.7 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