COPD diagnosis must improve, says audit

The accuracy of COPD diagnosis needs to improve to avoid high cost, unsafe, and clinically ineffective treatments being provided to people who do not have COPD, a damning report has found.

Published by the UK’s Royal College of Physicians the report, COPD in England—Finding the Measure of Success also suggests that nicotine replacement therapy, targeted drug treatment, and pulmonary rehabilitation, are underused.

“Anyone with a Medical Research Council (MRC) breathlessness grade of 3 or more should be offered and encouraged to do pulmonary rehabilitation by their primary care health professional and have timely and easy access to an appropriate provider of this evidence-based therapy” the report states.

It also calls for ‘the accurate and early diagnosis of COPD’ to be prioritised and stresses that GPs take a ‘person-centred approach’ to ensure that patients with severe forms of the disease are identified for optimal therapies.

The report follows the publication of data from primary care in Wales and combines publicly available data from 2014-15 for England with audit data from Welsh general practices.

Dr Noel Baxter, a respiratory GP specialist and clinical lead for primary care work stream said, “It will come as no surprise to people working in and with general practice who are interested in outcomes for people with COPD that the high achieving Quality and Outcomes Framework (QOF) results have provided false assurance about the quality of care for these people.

Detailed, coded data from Welsh general practice has raised the alarm about how confident we can be about the metrics we are measuring and, subsequently, about what is actually happening in terms of the quality of diagnosis and the utilisation of the right interventions.”

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