A snapshot of chronic obstructive pulmonary disease management in general practice in Ireland
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ORIGINAL ARTICLE
A snapshot of chronic obstructive pulmonary disease management in general practice in Ireland Liam O’Halloran 1 & Amy Purcell 1 & Eoin Ryan 1 & Jane O’Doherty 2 & Louise Troddyn 1 & Martin Slepanek 1 & Neil O’Driscoll 1 & Orlaith O’Reilly 1 & Paul Stassen 1 & Sarah Anne Bennett 1 & Raymond O’Connor 1,2 Received: 27 September 2020 / Accepted: 11 November 2020 # Royal Academy of Medicine in Ireland 2020
Abstract Background Chronic obstructive pulmonary disease (COPD) is a leading cause of death and disability. Its diagnosis, classification and management are complex. There is a paucity of data on the standard of COPD management in Irish general practice. Aims We studied whether COPD diagnosis and management was in accordance with the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines. We investigated if patients who were smokers had received smoking cessation advice. We examined whether influenza and pneumococcal vaccination had been given. Methods Ten general practices affiliated with the Irish Mid-West Specialist Training Programme in General Practice (GP) were searched, to determine which patients had a diagnosis of COPD. A data-collection audit tool was developed using GOLD 2019 guidelines. Results were tabulated in SPSS. Descriptive statistics were used. Results Of 482 patients studied, 91.7% were eligible for free GP care. In 49.4%, the diagnosis of COPD had been made appropriately. In 56.2%, there was no evidence that the stage of COPD had been formally assessed. Of the patients studied, 33.2% were deemed to be receiving appropriate therapy. Smoking status was documented in 99.6% of cases studied and 59.9% were ex-smokers, while 25.9% were current smokers. Appropriate smoking cessation advice had been offered to 71% of eligible patients. Influenza vaccine had been given to 66.2% in the previous 12 months. A total of 53.9% had ever received pneumococcal vaccination. Conclusions This study provides a comprehensive snapshot of care in Irish general practice for patients with COPD prior to introduction of the Chronic Disease Management programme (CDM). Keywords Chronic obstructive pulmonary disease . COPD . General practice . GOLD . Guideline . Management
Introduction Chronic respiratory diseases were the third leading cause of death in the world in 2017, with chronic obstructive pulmonary disease (COPD) causing the most respiratory disease attributable deaths and disability-adjusted life years (DALYs) [1]. Globally, the burden of COPD is projected to increase in coming decades because of continued exposure to
* Liam O’Halloran [email protected] 1
Mid-West Specialist Training Programme in General Practice, University of Limerick, Plassey, Limerick, Ireland
2
Department of General Practice, School of Medicine, University of Limerick, Plassey, Limerick, Ireland
COPD risk factors and an aging population [2]. Ireland has one of the highest standardised death rates attributable to COPD in Europe [3]. COPD prevalence in Ireland has never been measured at a national level. Ho
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