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Copd clinical audit

Sandra S Tøttenborg, Peter Lange, Reimar W Thomsen, Henrik Nielsen, Søren P Johnsen
OBJECTIVE: Socioeconomic differences in quality of care have been suggested to contribute to inequality in clinical prognosis of COPD. We examined socioeconomic differences in the quality of COPD outpatient care and the potential of a systematic quality improvement initiative in reducing potential socioeconomic differences. METHODS: A mandatory national quality improvement initiative has since 2008 monitored the quality of COPD care at all national pulmonary specialized outpatient clinics in Denmark using six evidence-based process performance measures...
April 2017: Respiratory Medicine
D J Brownridge, S T R Zaidi
WHAT IS KNOWN AND OBJECTIVE: Chronic obstructive pulmonary disease (COPD) is associated with significant morbidity and mortality, and frequent exacerbations are associated with an increased risk of death, deterioration in lung function and reduced quality of life. Current Australian guidelines developed by the Lung Foundation of Australia (the COPD-X Plan) recommends the use of a short course of corticosteroids and oral antibiotics (amoxycillin or doxycycline) as part of the treatment of an AECOPD; however, it was noted that clinical practice at the study hospital had deviated from these guidelines...
March 1, 2017: Journal of Clinical Pharmacy and Therapeutics
Myriam Calle Rubio, Bernardino Alcázar Navarrete, Joan B Soriano, Juan J Soler-Cataluña, José Miguel Rodríguez González-Moro, Manuel E Fuentes Ferrer, José Luis López-Campos
BACKGROUND: Chronic obstructive pulmonary disease (COPD) outpatients account for a large burden of usual care by respirologists. EPOCONSUL is the first national clinical audit conducted in Spain on the medical care for COPD patients delivered in outpatient respiratory clinics. We aimed to evaluate the clinical interventions and the degree of adherence to recommendations in outpatients of current COPD clinical practice guidelines. METHODOLOGY: This is an observational study with prospective recruitment (May 2014-May 2015) of patients with a COPD diagnosis as seen in outpatient respiratory clinics...
2017: International Journal of Chronic Obstructive Pulmonary Disease
Michael C Steiner, Derek Lowe, Katy Beckford, John Blakey, Charlotte E Bolton, Sarah Elkin, William D-C Man, C Michael Roberts, Louise Sewell, Paul Walker, Sally J Singh
BACKGROUND: Pulmonary rehabilitation (PR) improves exercise capacity and health status in patients with COPD, but many patients assessed for PR do not complete therapy. It is unknown whether socioeconomic deprivation associates with rates of completion of PR or the magnitude of clinical benefits bequeathed by PR. METHODS: PR services across England and Wales enrolled patients to the National PR audit in 2015. Deprivation was assessed using Index of Multiple Deprivation (IMD) derived from postcodes...
January 11, 2017: Thorax
L Goense, W A van Dijk, J A Govaert, P S N van Rossum, J P Ruurda, R van Hillegersberg
OBJECTIVE: The purpose of this study was to estimate the economic burden of postoperative complications after esophagectomy for cancer, in order to optimally allocate resources for quality improvement initiatives in the future. METHODS: A retrospective analysis of prospectively collected clinical and financial outcomes after esophageal cancer surgery in a tertiary referral center in the Netherlands was performed. Data was extracted from consecutive patients registered in the Dutch Upper GI Cancer Audit between 2011 and 2014 (n = 201)...
December 5, 2016: European Journal of Surgical Oncology
Mamta Ruparel, Jose Luis López-Campos, Ady Castro-Acosta, Sylvia Hartl, Francisco Pozo-Rodriguez, C Michael Roberts
Chronic obstructive pulmonary disease (COPD) care across Europe has high heterogeneity with respect to cost and the services available. Variations in length of stay (LOS) may be attributed to patient characteristics, resource and organisational characteristics, and/or the so-called hospital cluster effect. The European COPD Audit in 13 countries included data from 16 018 hospitalised patients. The recorded variables included information on patient and disease characteristics, and resources available. Variables associated with LOS were evaluated by a multivariate, multilevel analysis...
January 2016: ERJ Open Research
María José Bujalance-Zafra, Miguel Domínguez-Santaella, Antonio Baca-Osorio, Leovigildo Ginel-Mendoza, Francisco Jesús Fernández-Vargas, Rafael Poyato-Ramos
OBJECTIVE: To examine the impact of an intervention by Primary Care (PC) professionals of a Health District on the clinical outcomes for treating COPD exacerbations using a process and outcome indicators analysis (clinical audit). DESIGN: Observational, retrospective and prospective analysis cross-sectional audit of clinical practice SETTING: Malaga-Guadalhorce Sanitary District (DSMG). PARTICIPANTS: Patients with COPD exacerbations treated by the extra-hospital emergency services (n=523; 21% losses)...
September 27, 2016: Atencion Primaria
Jose Luis López-Campos, María Abad Arranz, Carmen Calero Acuña, Fernando Romero Valero, Ruth Ayerbe García, Antonio Hidalgo Molina, Ricardo I Aguilar Perez-Grovas, Francisco García Gil, Francisco Casas Maldonado, Laura Caballero Ballesteros, María Sánchez Palop, Dolores Pérez-Tejero, Alejandro Segado, Jose Calvo Bonachera, Bárbara Hernández Sierra, Adolfo Doménech, Macarena Arroyo Varela, Francisco González Vargas, Juan J Cruz Rueda
INTRODUCTION: This study is an analysis of a pilot COPD clinical audit that evaluated adherence to guidelines for patients with COPD in a stable disease phase during a routine visit in specialized secondary care outpatient clinics in order to identify the variables associated with the decision to step-up or step-down pharmacological treatment. METHODS: This study was a pilot clinical audit performed at hospital outpatient respiratory clinics in the region of Andalusia, Spain (eight provinces with over eight million inhabitants), in which 20% of centers in the area (catchment population 3,143,086 inhabitants) were invited to participate...
2016: International Journal of Chronic Obstructive Pulmonary Disease
Jose L López-Campos, Maria Abad Arranz, Carmen Calero-Acuña, Fernando Romero-Valero, Ruth Ayerbe-García, Antonio Hidalgo-Molina, Ricardo I Aguilar-Pérez-Grovas, Francisco García-Gil, Francisco Casas-Maldonado, Laura Caballero-Ballesteros, María Sánchez-Palop, Dolores Pérez-Tejero, Alejandro Segado, Jose Calvo-Bonachera, Bárbara Hernández-Sierra, Adolfo Doménech, Macarena Arroyo-Varela, Francisco González-Vargas, Juan J Cruz-Rueda
OBJECTIVES: Previous clinical audits of COPD have provided relevant information about medical intervention in exacerbation admissions. The present study aims to evaluate adherence to current guidelines in COPD through a clinical audit. METHODS: This is a pilot clinical audit performed in hospital outpatient respiratory clinics in Andalusia, Spain (eight provinces with more than 8 million inhabitants), including 9 centers (20% of the public centers in the area) between 2013 and 2014...
2016: PloS One
Jose Luis López-Campos, María Abad Arranz, Carmen Calero Acuña, Fernando Romero Valero, Ruth Ayerbe García, Antonio Hidalgo Molina, Ricardo Ismael Aguilar Pérez-Grovas, Francisco García Gil, Francisco Casas Maldonado, Laura Caballero Ballesteros, María Sánchez Palop, Dolores Pérez-Tejero, Alejandro Segado, Jose Calvo Bonachera, Bárbara Hernández Sierra, Adolfo Doménech, Macarena Arroyo Varela, Francisco González Vargas, Juan Jose Cruz Rueda
OBJECTIVES: Previous clinical audits for chronic obstructive pulmonary disease (COPD) have provided valuable information on the clinical care delivered to patients admitted to medical wards because of COPD exacerbations. However, clinical audits of COPD in an outpatient setting are scarce and no methodological guidelines are currently available. Based on our previous experience, herein we describe a clinical audit for COPD patients in specialized outpatient clinics with the overall goal of establishing a potential methodological workflow...
2015: PloS One
Alessandro Brunelli, Vasileios Tentzeris, Alberto Sandri, Alexandra McKenna, Shan Liung Liew, Richard Milton, Nilanjan Chaudhuri, Emmanuel Kefaloyannis, Kostas Papagiannopoulos
OBJECTIVE: To develop a clinically risk-adjusted financial model to estimate the cost associated with a video-assisted thoracoscopic surgery (VATS) lobectomy programme. METHODS: Prospectively collected data of 236 VATS lobectomy patients (August 2012-December 2013) were analysed retrospectively. Fixed and variable intraoperative and postoperative costs were retrieved from the Hospital Accounting Department. Baseline and surgical variables were tested for a possible association with total cost using a multivariable linear regression and bootstrap analyses...
May 2016: European Journal of Cardio-thoracic Surgery
Vivien Essel, Unita van Vuuren, Angela De Sa, Srini Govender, Katie Murie, Arina Schlemmer, Colette Gunst, Mosedi Namane, Andrew Boulle, Elma de Vries
BACKGROUND: An integrated audit tool was developed for five chronic diseases, namely diabetes, hypertension, asthma, chronic obstructive pulmonary disease and epilepsy. Annual audits have been done in the Western Cape Metro district since 2009. The year 2012 was the first year that all six districts in South Africa's Western Cape Province participated in the audit process. AIM: To determine whether clinical audits improve chronic disease care in health districts over time...
2015: African Journal of Primary Health Care & Family Medicine
Aarash Saleh, José Luis López-Campos, Sylvia Hartl, Francisco Pozo-Rodríguez, C Michael Roberts
OBJECTIVE: There is controversy regarding the significance of radiological consolidation in the context of COPD exacerbation (eCOPD). While some studies into eCOPD exclude these cases, consolidation is a common feature of eCOPD admissions in real practice. This study aims to address the question of whether consolidation in eCOPD is a distinct clinical phenotype with implications for management decisions and outcomes. PATIENTS AND METHODS: The European COPD Audit was carried out in 384 hospitals from 13 European countries between 2010 and 2011 to analyze guideline adherence in eCOPD...
2015: PloS One
A Soltani, D Reid, K Wills, E H Walters
BACKGROUND AND AIM: To determine predictors of short- and long-term outcomes in patients with acute exacerbation of chronic obstructive pulmonary disease (COPD) (AECOPD) presenting to hospital. METHODS: A prospective clinical audit of AECOPD attendances to the only public acute general hospital in Southern Tasmania, Australia. Out of 416 attendances with AECOPD to the emergency department (ED) between November 2006 and July 2008, 150 patients with 218 attendances were followed to March 2009...
September 2015: Internal Medicine Journal
Jose Luis López-Campos, Sylvia Hartl, Francisco Pozo-Rodriguez, C Michael Roberts
OBJECTIVE: Appropriate use of antibiotics in the management of hospitalised patients with COPD exacerbations is defined within the GOLD strategy. This paper analyses the factors associated with antibiotic prescribing in patients to better understand how prescribing may be improved. METHODS: The European COPD audit was a study of clinical care in 384 hospitals from 13 European countries between 2010 and 2011 enrolling 16018 patients. Those admitted to hospital due to a clinician-made diagnosis of exacerbation of COPD at the time of discharge were audited...
2015: PloS One
Jose Luis Lopez-Campos, Luis Jara-Palomares, Xavier Muñoz, Víctor Bustamante, Esther Barreiro
Despite the overwhelming evidence justifying the use of non-invasive ventilation (NIV) for providing ventilatory support in chronic obstructive pulmonary disease (COPD) exacerbations, recent studies demonstrated that its application in real-life settings remains suboptimal. European clinical audits have shown that 1) NIV is not invariably available, 2) its availability depends on countries and hospital sizes, and 3) numerous centers declare their inability to provide NIV to all of the eligible patients presenting throughout the year...
April 2015: Annals of Thoracic Medicine
F Pozo-Rodríguez, A Castro-Acosta, C J Alvarez, J L López-Campos, A Forte, A López-Quilez, A Agustí, V Abraira
BACKGROUND: Previous studies have demonstrated significant variability in the processes of care and outcomes of chronic obstructive pulmonary disease (COPD) exacerbations. The AUDIPOC is a Spanish nationwide clinical audit that identified large between-hospital variations in care and clinical outcomes. Here, we test the hypothesis that these variations can be attributed to either patient characteristics, hospital characteristics and/or the so-called hospital-clustering effect, which indicates that patients with similar characteristics may experience different processes of care and outcomes depending on the hospital to which they are admitted...
September 2015: International Journal of Clinical Practice
Joan Escarrabill, Elena Torrente, Cristina Esquinas, Carme Hernández, Eduard Monsó, Montserrat Freixas, Pere Almagro, Ricard Tresserras
UNLABELLED: Hospitalizations for acute exacerbation of COPD (AECOPD) generate high consumption of health resources, frequent readmissions and high mortality. The MAG -1 study aims to identify critical points to improve the care process of severe AECOPD requiring hospitalization. METHODS: Observational study, with review of clinical records of patients admitted to hospitals of the Catalan public network for AECOPD. The centers were classified into 3 groups according to the number of discharges/year...
October 2015: Archivos de Bronconeumología
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