Clinical audit of COPD in outpatient respiratory clinics in Spain: the EPOCONSUL study.

Background: Chronic obstructive pulmonary disease (COPD) outpatients account for a large burden of usual care by respirologists. EPOCONSUL is the first national clinical audit conducted in Spain on the medical care for COPD patients delivered in outpatient respiratory clinics. We aimed to evaluate t...

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Autores: Calle Rubio, Myriam, Alcázar Navarrete, Bernardino, Soriano, Joan B, Soler-Cataluña, Juan J, Rodríguez González-Moro, José Miguel, Fuentes Ferrer, Manuel E, Lopez-Campos, Jose Luis
Tipo de recurso: artículo
Fecha de publicación:2017
País:España
Institución:Instituto de Salud Carlos III (ISCIII)
Repositorio:Repisalud
Idioma:inglés
OAI Identifier:oai:repisalud.isciii.es:20.500.12105/25230
Acceso en línea:https://hdl.handle.net/20.500.12105/25230
Access Level:acceso abierto
Palabra clave:Adherence
Chronic obstructive pulmonary disease
Clinical audit
Clinical guidelines
Medical care
Aged
Cross-Sectional Studies
Delivery of Health Care
Exercise Tolerance
Female
Guideline Adherence
Humans
Lung
Male
Medical Audit
Middle Aged
Outpatient Clinics, Hospital
Practice Guidelines as Topic
Practice Patterns, Physicians'
Process Assessment, Health Care
Prospective Studies
Pulmonary Disease, Chronic Obstructive
Pulmonary Medicine
Pulmonologists
Referral and Consultation
Severity of Illness Index
Spain
Treatment Outcome
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spelling Clinical audit of COPD in outpatient respiratory clinics in Spain: the EPOCONSUL study.Calle Rubio, MyriamAlcázar Navarrete, BernardinoSoriano, Joan BSoler-Cataluña, Juan JRodríguez González-Moro, José MiguelFuentes Ferrer, Manuel ELopez-Campos, Jose LuisAdherenceChronic obstructive pulmonary diseaseClinical auditClinical guidelinesMedical careAgedCross-Sectional StudiesDelivery of Health CareExercise ToleranceFemaleGuideline AdherenceHumansLungMaleMedical AuditMiddle AgedOutpatient Clinics, HospitalPractice Guidelines as TopicPractice Patterns, Physicians'Process Assessment, Health CareProspective StudiesPulmonary Disease, Chronic ObstructivePulmonary MedicinePulmonologistsReferral and ConsultationSeverity of Illness IndexSpainTreatment OutcomeBackground: Chronic obstructive pulmonary disease (COPD) outpatients account for a large burden of usual care by respirologists. EPOCONSUL is the first national clinical audit conducted in Spain on the medical care for COPD patients delivered in outpatient respiratory clinics. We aimed to evaluate the clinical interventions and the degree of adherence to recommendations in outpatients of current COPD clinical practice guidelines. Methodology: This is an observational study with prospective recruitment (May 2014-May 2015) of patients with a COPD diagnosis as seen in outpatient respiratory clinics. The information collected was historical in nature as for the clinical data of the last and previous consultations, and the information concerning hospital resources was concurrent. Results: A total of 17,893 clinical records of COPD patients in outpatient respiratory clinics from 59 Spanish hospitals were evaluated. Of the 5,726 patients selected, 4,508 (78.7%) were eligible. Overall, 12.1% of COPD patients did not fulfill a diagnostic spirometry criteria. Considerable variability existed in the available resources and work organization of the hospitals, although the majority were university hospitals with respiratory inpatient units. There was insufficient implementation of clinical guidelines in preventive and educational matters. In contrast, quantitative evaluation of dyspnea grade (81.9%) and exacerbation history (70.9%) were more frequently performed. Only 12.4% had COPD severity calculated according to the Body mass index, airflow Obstruction, Dyspnoea and Exercise capacity (BODE) index. Phenotype characteristics according to Spanish National Guideline for COPD were determined in 46.3% of the audited patients, and the risk evaluation according to Global initiative for chronic Obstructive Lung Disease was estimated only in 21.9%. Conclusion: The EPOCONSUL study reports the current situation of medical care for COPD patients in outpatient clinics in Spain, revealing its variability, strengths, and weaknesses. This information has to be accounted for by health managers to define corrective strategies and maximize good clinical practice.20242024-10-2320172017-01-2520172017-01-25research articlehttp://purl.org/coar/resource_type/c_2df8fbb1VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articlehttps://hdl.handle.net/20.500.12105/25230reponame:Repisaludinstname:Instituto de Salud Carlos III (ISCIII)Inglésengopen accesshttp://purl.org/coar/access_right/c_abf2Attribution-NonCommercial 4.0 Internationalhttp://creativecommons.org/licenses/by-nc/4.0/info:eu-repo/semantics/openAccessoai:repisalud.isciii.es:20.500.12105/252302026-06-12T12:43:37Z
dc.title.none.fl_str_mv Clinical audit of COPD in outpatient respiratory clinics in Spain: the EPOCONSUL study.
title Clinical audit of COPD in outpatient respiratory clinics in Spain: the EPOCONSUL study.
spellingShingle Clinical audit of COPD in outpatient respiratory clinics in Spain: the EPOCONSUL study.
Calle Rubio, Myriam
Adherence
Chronic obstructive pulmonary disease
Clinical audit
Clinical guidelines
Medical care
Aged
Cross-Sectional Studies
Delivery of Health Care
Exercise Tolerance
Female
Guideline Adherence
Humans
Lung
Male
Medical Audit
Middle Aged
Outpatient Clinics, Hospital
Practice Guidelines as Topic
Practice Patterns, Physicians'
Process Assessment, Health Care
Prospective Studies
Pulmonary Disease, Chronic Obstructive
Pulmonary Medicine
Pulmonologists
Referral and Consultation
Severity of Illness Index
Spain
Treatment Outcome
title_short Clinical audit of COPD in outpatient respiratory clinics in Spain: the EPOCONSUL study.
title_full Clinical audit of COPD in outpatient respiratory clinics in Spain: the EPOCONSUL study.
title_fullStr Clinical audit of COPD in outpatient respiratory clinics in Spain: the EPOCONSUL study.
title_full_unstemmed Clinical audit of COPD in outpatient respiratory clinics in Spain: the EPOCONSUL study.
title_sort Clinical audit of COPD in outpatient respiratory clinics in Spain: the EPOCONSUL study.
dc.creator.none.fl_str_mv Calle Rubio, Myriam
Alcázar Navarrete, Bernardino
Soriano, Joan B
Soler-Cataluña, Juan J
Rodríguez González-Moro, José Miguel
Fuentes Ferrer, Manuel E
Lopez-Campos, Jose Luis
author Calle Rubio, Myriam
author_facet Calle Rubio, Myriam
Alcázar Navarrete, Bernardino
Soriano, Joan B
Soler-Cataluña, Juan J
Rodríguez González-Moro, José Miguel
Fuentes Ferrer, Manuel E
Lopez-Campos, Jose Luis
author_role author
author2 Alcázar Navarrete, Bernardino
Soriano, Joan B
Soler-Cataluña, Juan J
Rodríguez González-Moro, José Miguel
Fuentes Ferrer, Manuel E
Lopez-Campos, Jose Luis
author2_role author
author
author
author
author
author
dc.contributor.none.fl_str_mv
dc.subject.none.fl_str_mv Adherence
Chronic obstructive pulmonary disease
Clinical audit
Clinical guidelines
Medical care
Aged
Cross-Sectional Studies
Delivery of Health Care
Exercise Tolerance
Female
Guideline Adherence
Humans
Lung
Male
Medical Audit
Middle Aged
Outpatient Clinics, Hospital
Practice Guidelines as Topic
Practice Patterns, Physicians'
Process Assessment, Health Care
Prospective Studies
Pulmonary Disease, Chronic Obstructive
Pulmonary Medicine
Pulmonologists
Referral and Consultation
Severity of Illness Index
Spain
Treatment Outcome
topic Adherence
Chronic obstructive pulmonary disease
Clinical audit
Clinical guidelines
Medical care
Aged
Cross-Sectional Studies
Delivery of Health Care
Exercise Tolerance
Female
Guideline Adherence
Humans
Lung
Male
Medical Audit
Middle Aged
Outpatient Clinics, Hospital
Practice Guidelines as Topic
Practice Patterns, Physicians'
Process Assessment, Health Care
Prospective Studies
Pulmonary Disease, Chronic Obstructive
Pulmonary Medicine
Pulmonologists
Referral and Consultation
Severity of Illness Index
Spain
Treatment Outcome
description Background: Chronic obstructive pulmonary disease (COPD) outpatients account for a large burden of usual care by respirologists. EPOCONSUL is the first national clinical audit conducted in Spain on the medical care for COPD patients delivered in outpatient respiratory clinics. We aimed to evaluate the clinical interventions and the degree of adherence to recommendations in outpatients of current COPD clinical practice guidelines. Methodology: This is an observational study with prospective recruitment (May 2014-May 2015) of patients with a COPD diagnosis as seen in outpatient respiratory clinics. The information collected was historical in nature as for the clinical data of the last and previous consultations, and the information concerning hospital resources was concurrent. Results: A total of 17,893 clinical records of COPD patients in outpatient respiratory clinics from 59 Spanish hospitals were evaluated. Of the 5,726 patients selected, 4,508 (78.7%) were eligible. Overall, 12.1% of COPD patients did not fulfill a diagnostic spirometry criteria. Considerable variability existed in the available resources and work organization of the hospitals, although the majority were university hospitals with respiratory inpatient units. There was insufficient implementation of clinical guidelines in preventive and educational matters. In contrast, quantitative evaluation of dyspnea grade (81.9%) and exacerbation history (70.9%) were more frequently performed. Only 12.4% had COPD severity calculated according to the Body mass index, airflow Obstruction, Dyspnoea and Exercise capacity (BODE) index. Phenotype characteristics according to Spanish National Guideline for COPD were determined in 46.3% of the audited patients, and the risk evaluation according to Global initiative for chronic Obstructive Lung Disease was estimated only in 21.9%. Conclusion: The EPOCONSUL study reports the current situation of medical care for COPD patients in outpatient clinics in Spain, revealing its variability, strengths, and weaknesses. This information has to be accounted for by health managers to define corrective strategies and maximize good clinical practice.
publishDate 2017
dc.date.none.fl_str_mv 2017
2017-01-25
2017
2017-01-25
2024
2024-10-23
dc.type.none.fl_str_mv research article
http://purl.org/coar/resource_type/c_2df8fbb1
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://hdl.handle.net/20.500.12105/25230
url https://hdl.handle.net/20.500.12105/25230
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
Attribution-NonCommercial 4.0 International
http://creativecommons.org/licenses/by-nc/4.0/
eu_rights_str_mv openAccess
dc.source.none.fl_str_mv reponame:Repisalud
instname:Instituto de Salud Carlos III (ISCIII)
instname_str Instituto de Salud Carlos III (ISCIII)
reponame_str Repisalud
collection Repisalud
repository.name.fl_str_mv
repository.mail.fl_str_mv
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