An audit of chronic obstructive pulmonary disease (COPD) management in an outpatient setting. Teoh, K. J. A., Lim, W. H. E., Panchanathan, K., & Ng, A. W. K. Annals of the Academy of Medicine Singapore, 42(9 SUPPL. 1):S245, 2013. ![An audit of chronic obstructive pulmonary disease (COPD) management in an outpatient setting [link]](https://bibbase.org/img/filetypes/link.svg "link")
Paper abstract bibtex Introduction: Patients with chronic obstructive pulmonary disease (COPD) require long-term follow-up because of debilitating lung disease characterised by irreversible airflow obstruction and progressive decline of lung function. Method(s): Case note review of patients attending the Respiratory Medicine Outpatient Clinic in January 2013. Result(s): Of 2348 scheduled clinic attendances, 242 were attributed to COPD; 197 (81.4%) patients turned up; 55 attended the COPD clinic where they were also attended to by case managers. In all, 188 clinical notes were available for review. Diagnosis was confirmed by spirometry in 154 (81.9%) patients; most patients had advanced disease, 74 (48.1%) stage 3, 22 (14.3%) stage 4. Diagnosis was clinical in 34. A total of 123 (65.4%) patients had quit smoking and 36 (19%) had recent hospitalisation for an exacerbation. CAT (COPD Assessment Test) score was \textless10 (low impact) in 37 (75.5%) patients, and 10 to 20 (medium impact) 12 (24.5%) patients; mean MMRC score was 1.86. All except one were on bronchodilators; 78 had long acting bronchodilators. Inhaled corticosteroids or combination inhalers were prescribed for 151 (80.3%) patients, including 36 patients with Stage 1, 2 COPD. Thirty (16.0%) patients without airflow obstruction were given prescriptions for COPD, suggesting inappropriate treatment. Compliance to influenza vaccination was noted to be better in patients seen at the COPD clinic (92% vs 70%). Discussion & Conclusion(s): Areas for improvement identified are: (i) Confirmation of diagnosis to be performed where possible to avoid inappropriate treatment. (ii) Overtreatment can be avoided by adhering to treatment guidelines. (iii) Compliance to annual influenza vaccination.
@article{teoh_audit_2013,
title = {An audit of chronic obstructive pulmonary disease ({COPD}) management in an outpatient setting},
volume = {42},
issn = {0304-4602},
url = {http://www.annals.edu.sg/pdf/42VolNo9Sep2013/SHBC_2013_041013.pdf http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=reference&D=emed14&NEWS=N&AN=71796894},
abstract = {Introduction: Patients with chronic obstructive pulmonary disease (COPD) require long-term follow-up because of debilitating lung disease characterised by irreversible airflow obstruction and progressive decline of lung function. Method(s): Case note review of patients attending the Respiratory Medicine Outpatient Clinic in January 2013. Result(s): Of 2348 scheduled clinic attendances, 242 were attributed to COPD; 197 (81.4\%) patients turned up; 55 attended the COPD clinic where they were also attended to by case managers. In all, 188 clinical notes were available for review. Diagnosis was confirmed by spirometry in 154 (81.9\%) patients; most patients had advanced disease, 74 (48.1\%) stage 3, 22 (14.3\%) stage 4. Diagnosis was clinical in 34. A total of 123 (65.4\%) patients had quit smoking and 36 (19\%) had recent hospitalisation for an exacerbation. CAT (COPD Assessment Test) score was {\textless}10 (low impact) in 37 (75.5\%) patients, and 10 to 20 (medium impact) 12 (24.5\%) patients; mean MMRC score was 1.86. All except one were on bronchodilators; 78 had long acting bronchodilators. Inhaled corticosteroids or combination inhalers were prescribed for 151 (80.3\%) patients, including 36 patients with Stage 1, 2 COPD. Thirty (16.0\%) patients without airflow obstruction were given prescriptions for COPD, suggesting inappropriate treatment. Compliance to influenza vaccination was noted to be better in patients seen at the COPD clinic (92\% vs 70\%). Discussion \& Conclusion(s): Areas for improvement identified are: (i) Confirmation of diagnosis to be performed where possible to avoid inappropriate treatment. (ii) Overtreatment can be avoided by adhering to treatment guidelines. (iii) Compliance to annual influenza vaccination.},
language = {English},
number = {9 SUPPL. 1},
journal = {Annals of the Academy of Medicine Singapore},
author = {Teoh, K. J. A. and Lim, W. H. E. and Panchanathan, K. and Ng, A. W. K.},
year = {2013},
keywords = {*Singapore, *chronic obstructive lung disease, *disease management, *health, *human, *medical audit, *outpatient, airway obstruction, bronchodilating agent, case manager, corticosteroid, diagnosis, follow up, hospital, influenza vaccination, inhaler, lung disease, lung function, outpatient department, patient, prescription, smoking cessation, spirometry},
pages = {S245},
}
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Result(s): Of 2348 scheduled clinic attendances, 242 were attributed to COPD; 197 (81.4%) patients turned up; 55 attended the COPD clinic where they were also attended to by case managers. In all, 188 clinical notes were available for review. Diagnosis was confirmed by spirometry in 154 (81.9%) patients; most patients had advanced disease, 74 (48.1%) stage 3, 22 (14.3%) stage 4. Diagnosis was clinical in 34. A total of 123 (65.4%) patients had quit smoking and 36 (19%) had recent hospitalisation for an exacerbation. CAT (COPD Assessment Test) score was \\textless10 (low impact) in 37 (75.5%) patients, and 10 to 20 (medium impact) 12 (24.5%) patients; mean MMRC score was 1.86. All except one were on bronchodilators; 78 had long acting bronchodilators. Inhaled corticosteroids or combination inhalers were prescribed for 151 (80.3%) patients, including 36 patients with Stage 1, 2 COPD. Thirty (16.0%) patients without airflow obstruction were given prescriptions for COPD, suggesting inappropriate treatment. Compliance to influenza vaccination was noted to be better in patients seen at the COPD clinic (92% vs 70%). Discussion & Conclusion(s): Areas for improvement identified are: (i) Confirmation of diagnosis to be performed where possible to avoid inappropriate treatment. (ii) Overtreatment can be avoided by adhering to treatment guidelines. 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