1. Översiktlig projektbeskrivning

Engelsk titel

Adherence to diagnostic guidelines and quality indicators in asthma and COPD

Sammanfattning av projektet

Purpose:
To study the clinical evaluation of patients with asthma and COPD in Skaraborg primary care, Sweden, with a focus on adherence to recommended guidelines and quality indicators, at initial visits and at follow-ups.

Methods:
Visits at health care centres in Skaraborg, Sweden, are documented in computerized medical records constituting the Skaraborg Primary Care Database (SPCD). In a register-based retrospective observational study, patients diagnosed with asthma or COPD during 2000-2005 (n = 12 328) were identified. In a 5 % random sample (n = 623), information on performed investigations at initial visits and at follow-up during 2004-2005 was collected. Compliance with procedures as recommended by national guidelines was used for quality assessment.

Results:
Among 499 patients with asthma 167 (33 %) were investigated with spirometry or Peak Expiratory Flow (PEF) during initial visits in agreement with guidelines. Correspondingly, 40 out of 124 patients with COPD (32 %) were investigated by spirometry in agreement.

During follow-up, evaluation in agreement with guidelines was performed in
130 (60 %) of patients with asthma and in 35 patients out of 77 (45 %) with COPD. Prescribing of ICS reached quality target, still every second patient made an acute visit.

Conclusion:
Adherence to recommended guidelines in asthma/COPD was low. Despite prescribing of ICS according to recommendation, patients seem uncontrolled in their disease, since acute visits were common. Our study therefor indicate a need quality improvement in the clinical evaluation and routine of care of patients with asthma and COPD.

Typ av projekt

Forskningsprojekt

MeSH-termer för att beskriva ämnesområdet

Inlagda MeSH-termer

Adolescent

A person 13 to 18 years of age.

Adult

A person having attained full growth or maturity. Adults are of 19 through 44 years of age.

Aged

A person 65 through 79 years of age. For a person older than 79 years, AGED, 80 AND OVER is available.

Asthma

A form of bronchial disorder associated with airway obstruction, marked by recurrent attacks of paroxysmal dyspnea, with wheezing due to spasmodic contraction of the bronchi.

Diagnosis

The determination of the nature of a disease or condition, or the distinguishing of one disease or condition from another. Assessment may be made through physical examination, laboratory tests, or the likes. Computerized programs may be used to enhance the decision-making process.

Child

A person 6 to 12 years of age. An individual 2 to 5 years old is CHILD, PRESCHOOL.

Child, Preschool

A child between the ages of 2 and 5.

Female

Humans

Members of the species Homo sapiens.

Infant

A child between 1 and 23 months of age.

Infant, Newborn

An infant during the first month after birth.

Male

Middle Aged

Practice Guidelines as Topic

Directions or principles presenting current or future rules of policy for assisting health care practitioners in patient care decisions regarding diagnosis, therapy, or related clinical circumstances. The guidelines may be developed by government agencies at any level, institutions, professional societies, governing boards, or by the convening of expert panels. The guidelines form a basis for the evaluation of all aspects of health care and delivery.

Primary Health Care

Care which provides integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs, developing a sustained partnership with patients, and practicing in the context of family and community. (JAMA 1995;273(3):192)

Pulmonary Disease, Chronic Obstructive

A disease of chronic diffuse irreversible airflow obstruction. Subcategories of COPD include CHRONIC BRONCHITIS and PULMONARY EMPHYSEMA.

Sweden

Projektets delaktighet i utbildning

Avhandling
D-uppsats / Magisterexamen
C-uppsats / Kandidatexamen
ST-läkarutbildning
Annan utbildning
Ej del i utbildning

3. Processen och projektets redovisning

Pågående aktiviteter

Planering och förberedelse före datainsamling
Datainsamling pågår
Analys av insamlade data pågår
Författande av skriftlig redovisning / publikation pågår
En eller flera publikationer från projektet är publicerade
Slutfört och inget mer görs inom ramen för detta projekt

Projektstart (när planeringen påbörjas och börjar dokumenteras skriftligt)

2007-03-01

Datum då projektet är slutrapporterat

2009-03-13

Publikationer från detta projekt

1. Adherence to diagnostic guidelines and quality indicators in asthma and COPD in Swedish primary care.

   Weidinger Paolina, Nilsson J Lars G, Lindblad Ulf.

   Pharmacoepidemiology and drug safety 2009

   [Links: PMID: 19288473 | DOI länk][Source: PubMed®]