Community Assessment of COPD Health Care (COACH) study: a clinical audit on primary care performance variability in COPD care
COACH study investigators.
| Autores: | , , , , , , , , , , , |
|---|---|
| Formato: | artículo |
| Estado: | Versión publicada |
| Fecha de publicación: | 2018 |
| País: | España |
| Recursos: | Consejo Superior de Investigaciones Científicas (CSIC) |
| Repositorio: | DIGITAL.CSIC. Repositorio Institucional del CSIC |
| OAI Identifier: | oai:digital.csic.es:10261/180340 |
| Acesso em linha: | http://hdl.handle.net/10261/180340 |
| Access Level: | acceso abierto |
| Palavra-chave: | COPD Clinical audit Primary care Quality of care Variability |
| id |
ES_f5d06ccbba4ea4cd8bf779772115aa77 |
|---|---|
| oai_identifier_str |
oai:digital.csic.es:10261/180340 |
| network_acronym_str |
ES |
| network_name_str |
España |
| repository_id_str |
|
| spelling |
Community Assessment of COPD Health Care (COACH) study: a clinical audit on primary care performance variability in COPD careAbad Arranz, MaríaMorán-Rodríguez, AnaMascarós Balaguer, EnriqueQuintana Velasco, CarmenAbad Polo, LauraNúñez Palomo, SaraGonzálvez Rey, JaimeFernández Vargas, Ana MaríaHidalgo Requena, AntonioHelguera Quevedo, José ManuelGarcía Pardo, MarinaLópez-Campos, J. L.COPDClinical auditPrimary careQuality of careVariabilityCOACH study investigators.[Background] A thorough evaluation of the adequacy of clinical practice in a designated health care setting and temporal context is key for clinical care improvement. This study aimed to perform a clinical audit of primary care to evaluate clinical care delivered to patients with COPD in routine clinical practice.[Methods] The Community Assessment of COPD Health Care (COACH) study was an observational, multicenter, nationwide, non-interventional, retrospective, clinical audit of randomly selected primary care centers in Spain. Two different databases were built: the resources and organization database and the clinical database. From January 1, 2015 to December 31, 2016 consecutive clinical cases of COPD in each participating primary care center (PCC) were audited. For descriptive purposes, we collected data regarding the age at diagnosis of COPD and the age at audit, gender, the setting of the PCC (rural/urban), and comorbidities for each patient. Two guidelines widely and uniformly used in Spain were carefully reviewed to establish a benchmark of adequacy for the audited cases. Clinical performance was analyzed at the patient, center, and regional levels. The degree of adequacy was categorized as excellent (> 80%), good (60–80%), adequate (40–59%), inadequate (20–39%), and highly inadequate (< 20%).[Results] During the study 4307 cases from 63 primary care centers in 6 regions of the country were audited. Most evaluated parameters were judged to fall in the inadequate performance category. A correct diagnosis based on previous exposure plus spirometric obstruction was made in an average of 17.6% of cases, ranging from 9.8 to 23.3% depending on the region. During the audited visit, only 67 (1.6%) patients had current post-bronchodilator obstructive spirometry; 184 (4.3%) patients had current post-bronchodilator obstructive spirometry during either the audited or initial diagnostic visit. Evaluation of dyspnea was performed in 11.1% of cases. Regarding treatment, 33.6% received no maintenance inhaled therapies (ranging from 31.3% in GOLD A to 7.0% in GOLD D). The two most frequently registered items were exacerbations in the previous year (81.4%) and influenza vaccination (87.7%).[Conclusions] The results of this audit revealed a large variability in clinical performance across centers, which was not fully attributable to the severity of the disease.This study received an unrestricted grant from Boehringer Ingelheim, Spain.Peer reviewedBioMed CentralBoehringer Ingelheim FondsConsejo Superior de Investigaciones Científicas [https://ror.org/02gfc7t72]201920192018info:eu-repo/semantics/articlehttp://purl.org/coar/resource_type/c_6501Publisher's versioninfo:eu-repo/semantics/publishedVersionhttp://hdl.handle.net/10261/180340reponame:DIGITAL.CSIC. Repositorio Institucional del CSICinstname:Consejo Superior de Investigaciones Científicas (CSIC)Ingléshttps://doi.org/10.1186/s12874-018-0528-4Síinfo:eu-repo/semantics/openAccessoai:digital.csic.es:10261/1803402026-05-22T06:33:51Z |
| dc.title.none.fl_str_mv |
Community Assessment of COPD Health Care (COACH) study: a clinical audit on primary care performance variability in COPD care |
| title |
Community Assessment of COPD Health Care (COACH) study: a clinical audit on primary care performance variability in COPD care |
| spellingShingle |
Community Assessment of COPD Health Care (COACH) study: a clinical audit on primary care performance variability in COPD care Abad Arranz, María COPD Clinical audit Primary care Quality of care Variability |
| title_short |
Community Assessment of COPD Health Care (COACH) study: a clinical audit on primary care performance variability in COPD care |
| title_full |
Community Assessment of COPD Health Care (COACH) study: a clinical audit on primary care performance variability in COPD care |
| title_fullStr |
Community Assessment of COPD Health Care (COACH) study: a clinical audit on primary care performance variability in COPD care |
| title_full_unstemmed |
Community Assessment of COPD Health Care (COACH) study: a clinical audit on primary care performance variability in COPD care |
| title_sort |
Community Assessment of COPD Health Care (COACH) study: a clinical audit on primary care performance variability in COPD care |
| dc.creator.none.fl_str_mv |
Abad Arranz, María Morán-Rodríguez, Ana Mascarós Balaguer, Enrique Quintana Velasco, Carmen Abad Polo, Laura Núñez Palomo, Sara Gonzálvez Rey, Jaime Fernández Vargas, Ana María Hidalgo Requena, Antonio Helguera Quevedo, José Manuel García Pardo, Marina López-Campos, J. L. |
| author |
Abad Arranz, María |
| author_facet |
Abad Arranz, María Morán-Rodríguez, Ana Mascarós Balaguer, Enrique Quintana Velasco, Carmen Abad Polo, Laura Núñez Palomo, Sara Gonzálvez Rey, Jaime Fernández Vargas, Ana María Hidalgo Requena, Antonio Helguera Quevedo, José Manuel García Pardo, Marina López-Campos, J. L. |
| author_role |
author |
| author2 |
Morán-Rodríguez, Ana Mascarós Balaguer, Enrique Quintana Velasco, Carmen Abad Polo, Laura Núñez Palomo, Sara Gonzálvez Rey, Jaime Fernández Vargas, Ana María Hidalgo Requena, Antonio Helguera Quevedo, José Manuel García Pardo, Marina López-Campos, J. L. |
| author2_role |
author author author author author author author author author author author |
| dc.contributor.none.fl_str_mv |
Boehringer Ingelheim Fonds Consejo Superior de Investigaciones Científicas [https://ror.org/02gfc7t72] |
| dc.subject.none.fl_str_mv |
COPD Clinical audit Primary care Quality of care Variability |
| topic |
COPD Clinical audit Primary care Quality of care Variability |
| description |
COACH study investigators. |
| publishDate |
2018 |
| dc.date.none.fl_str_mv |
2018 2019 2019 |
| dc.type.none.fl_str_mv |
info:eu-repo/semantics/article http://purl.org/coar/resource_type/c_6501 Publisher's version info:eu-repo/semantics/publishedVersion |
| format |
article |
| status_str |
publishedVersion |
| dc.identifier.none.fl_str_mv |
http://hdl.handle.net/10261/180340 |
| url |
http://hdl.handle.net/10261/180340 |
| dc.language.none.fl_str_mv |
Inglés |
| language_invalid_str_mv |
Inglés |
| dc.relation.none.fl_str_mv |
https://doi.org/10.1186/s12874-018-0528-4 Sí |
| dc.rights.none.fl_str_mv |
info:eu-repo/semantics/openAccess |
| eu_rights_str_mv |
openAccess |
| dc.publisher.none.fl_str_mv |
BioMed Central |
| publisher.none.fl_str_mv |
BioMed Central |
| dc.source.none.fl_str_mv |
reponame:DIGITAL.CSIC. Repositorio Institucional del CSIC instname:Consejo Superior de Investigaciones Científicas (CSIC) |
| instname_str |
Consejo Superior de Investigaciones Científicas (CSIC) |
| reponame_str |
DIGITAL.CSIC. Repositorio Institucional del CSIC |
| collection |
DIGITAL.CSIC. Repositorio Institucional del CSIC |
| repository.name.fl_str_mv |
|
| repository.mail.fl_str_mv |
|
| _version_ |
1869424650949230592 |
| score |
15,811543 |