SESSION TITLE: Process Improvement in Obstructive Lung Disease Education, Pneumonia Readmissions and Rapid Response Systems I
SESSION TYPE: Original Investigation Poster
PRESENTED ON: Wednesday, October 28, 2015 at 01:30 PM - 02:30 PM
PURPOSE: Chronic obstructive pulmonary disease (COPD) is common among patients with cardiovascular disease (CVD), and in fact nearly a third of patients with COPD die of CV causes. Thus, increased screening and evaluation of patients with comorbid COPD and CVD is important and has the potential to improve CVD outcomes. This online point-of-care program aimed to empower cardiologists to screen and evaluate their CV patients both at risk of COPD or with COPD. The goals were to ensure COPD was correctly diagnosed, identify patients needing improved COPD control, and prompt cardiologists to refer to a respirologist when appropriate.
METHODS: 36 Canadian cardiologists completed surveys on up to 20 patients at risk of COPD (age ≥40 years, a smoking history of ≥10 pack-years, and ≥1 positive answer on the Canadian Lung Health Test), or with a current diagnosis, during routine visits. After entering a patient profile, the program prompted physicians with relevant information and recommendations.
RESULTS: Cardiologists entered 588 patients into the online program. Compared to the group with COPD, patients at risk of COPD were more likely to present with new or worsening CV symptoms (38% vs. 21%). Of the 143 patients at risk of COPD, 62 were newly referred for spirometry, and 43 were referred to an HCP for evaluation/confirmation of COPD. Out of 445 patients with COPD, 134 had not had spirometry to confirm diagnosis, while 42 were newly referred for confirmation of COPD.
CONCLUSIONS: The program shows promising results in terms of modifying cardiologists' behaviour to improve patient outcomes by increasing the number of patients who received spirometry for evaluation/confirmation of COPD.
CLINICAL IMPLICATIONS: Increased awareness of the presence of or potential for COPD among cardiologists' patients led to positive clinical change in the form of referrals for diagnosis or management of COPD.
DISCLOSURE: Mohit Bhutani: Consultant fee, speaker bureau, advisory committee, etc.: Received consultant fee Jafna Cox: Consultant fee, speaker bureau, advisory committee, etc.: Received consultant fee
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