Impact of omitting annual reviews for COPD on patient reported care quality– outcomes from the Asthma+Lung COPD patient passport

BackgroundRegular clinical reviews of people with COPD provide an opportunity to optimise management and are recommended in national and international guidelines. However, there are limited data about the relationship between having an annual review and other aspects of care quality, which might inf...

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Bibliographic Details
Published in:	BMJ open Vol. 14; no. 4; p. e080282
Main Authors:	Williams, Parris Jade, Bachir, Leena, Philip, Keir Elmslie James, Cumella, Andrew, Polkey, Mike, Laverty, Anthony A, Hopkinson, Nicholas S
Format:	Journal Article
Language:	English
Published:	England British Medical Journal Publishing Group 10-04-2024 BMJ Publishing Group LTD BMJ Publishing Group
Subjects:	Asthma Asthma - therapy Chronic obstructive pulmonary disease Coronaviruses COVID-19 vaccines Humans Inhalers Lung Medical referrals Patient Reported Outcome Measures Patients Pharmacists pulmonary disease, chronic obstructive Pulmonary Disease, Chronic Obstructive - drug therapy quality in health care Researchers Respiratory medicine respiratory medicine (see thoracic medicine) Surveys and Questionnaires United Kingdom > UK respiratory medicine (see thoracic medicine) quality in health care pulmonary disease, chronic obstructive
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Summary:	BackgroundRegular clinical reviews of people with COPD provide an opportunity to optimise management and are recommended in national and international guidelines. However, there are limited data about the relationship between having an annual review and other aspects of care quality, which might influence decision-making by healthcare professionals and commissioners.MethodUsing data from 74 827 people with COPD completing the Asthma+Lung UK COPD Patient Passport, between 2014 and 2022, we conducted adjusted logistic regression (adjusting for year) and compared receipt of key items of care between those reporting that they had had an annual review (65.3%) and those who did not (34.7%). To further capture patient experience, we also analysed 4228 free-text responses to the 2021 Asthma+Lung UK annual COPD survey to the question ‘What is the one thing that could improve your COPD care?’ResultsWe found that the absence of an annual review was associated with significantly worse COPD care across all domains studied; in particular, inhaler training (yes: 80.8% vs no: 38.4%, adjusted OR (AOR): 8.18, 95% CI (7.89 to 8.47), having a written care plan (89.6% vs 56.9%, AOR 6.68 (95% CI 6.35 to 7.05) and medication knowledge (72.6% vs 33.6%, AOR 5.73 (95% CI 5.51 to 5.96). Thematic analysis of the 2021 COPD survey responses identified three areas to improve care: (1) access and support from healthcare services, (2) improved treatment effectiveness and (3) interaction between COPD and the social environment.DiscussionFailure to deliver annual COPD reviews is associated with worse patient-reported experience of care quality. In parallel, people with COPD express a desire for greater support and access to healthcare services.
Bibliography:	Original research ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	2044-6055 2044-6055
DOI:	10.1136/bmjopen-2023-080282