Abstract
Introduction
Although COPD is a huge healthcare burden globally, differences in international management are difficult to analyse. This pilot study examines how COPD is managed in primary care in 11 countries: 3 UK (England, Scotland and Wales), 8 Non-UK (Netherlands, Spain, Republic of Ireland, Denmark, Sweden, Norway, Australia, and New Zealand).
Method
A multicentre questionnaire based pilot study was undertaken in at least 30 centres in each of 11 countries. Questionnaires were administered to a sample of 60 primary care physicians in each country (random sampling: 3 UK countries, 3 Non-UK countries; opportune sampling: 5 Non-UK countries) to measure themes which included: diagnosis, management, therapeutic interventions, use of referral for specialist care, attitudes to COPD, and guideline awareness.
Results
Main results are shown in table below.
Discussion
A better understanding of COPD management in different countries may allow for easier implementation of international guidelines and also highlight how best to organise the delivery of care.
COPD Themes UK only Range between all 11 countries p value (Chi-square)
Use of clinical, spirometry and reversibility to diagnose COPD 53.2% 44 — 84.6 % 0.004
Use of regular review 79.5% 50 — 83.3 % 0.003
Use of Bronchodilators as 1st line inhaler therapy 91.6% 56.5 — 97.4 % 0.000
Use of specialist secondary care 20% of the time 70.2% 52.2 — 97.4 % 0.022
COPD ranked as most important in clinical practice as compared to IHD, diabetes, asthma and depression 8.2% 2.4 — 10 % 0.001
Use of guidelines for COPD management 76.6% 20.7 — 91.4 % 0.000
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Foster, J. UK results from a pilot survey of international delivery of care for COPD. Prim Care Respir J 12, 64 (2003). https://doi.org/10.1038/pcrj.2003.27
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DOI: https://doi.org/10.1038/pcrj.2003.27