Does implementing COPD guidelines improve patient care and save money in practice?

Abstract

Objectives: To identify and assess the management of patients with COPD attending our practice asthma clinic by implementing protocols for the diagnosis and management of COPD, including reversibility testing. Design and subjects: All patients aged over 39 years attending the asthma clinic at The Roborough Surgery were included. We assessed the implementation of the protocols and analysed prescribing data in those found to have irreversible airflow obstruction. Results: COPD was found in 35/58 adults (60%) over 40 years, of these, 6 (17%) were irreversible. In irreversible patients, less inhaled steroids were prescribed, but this was offset by more anticholinergic prescriptions. The majority had had appropriate diagnostic tests, but the uptake of immunisation was 51% for influenza and 43% for pneumococcal infection. Conclusion: Applying COPD protocols did not reduce prescribing costs, but encouraged optimum patient care in terms of investigations, diagnosis, appropriate treatment and immunisation.