A centralised respiratory diagnostic service for primary care: a 4-year audit

Source: Prim Care Respir J

Follow this link for the fulltext

Date of publication: 19 March 2012

Publication type: Journal article – online first

In a nutshell: The literature shows that delayed or erroneous diagnosis of respiratory conditions may be common in primary care due to underuse of spirometry or poor spirometric technique. The Community Respiratory Assessment Unit (CRAU) was established to optimise diagnosis and treatment of respiratory disease by providing focused history-taking, quality-assured spirometry, and evidence-based guideline-derived management advice.

A cost-effectiveness model of smoking cessation based on a randomised controlled trial of varenicline versus placebo in patients with chronic obstructive pulmonary disease

Source: Expert Opinion on Pharmacotherapy, December 2011, vol. 12, part 17, pp. 2613-26

Follow this link for the abstract

Date of publication: December 2011

Publication type: Journal article

In a nutshell: Examined the cost-effectiveness of varenicline from the perspective of the healthcare systems of Spain (base case), the UK, France, Germany, Greece and Italy.  A Markov model was developed to determine the cost-effectiveness of varenicline as an aid to smoking cessation, compared to a placebo, in a COPD population. Cost-effectiveness was determined by the incremental cost per quality-adjusted life year (QALY) gained.  Results suggest that varenicline had a 95% probability of being cost effective at a threshold of 30,000 euros per QALY.

Length of publication:  24 pages

Some important notes: Original article may be available with an NHS Athens username; contact your local NHS library service for details.  Follow this link to find your local NHS Library

Acknowledgement: Medline

Review: Chronic obstructive pulmonary disease

Source: The Lancet, 2012, Early online, pp. 349-350

Follow this link for the abstract

Follow this link for the full-text

Date of publication: 5 February 2012

Publication type: Review article

In a nutshell: A review of chronic obstructive pulmonary disease (COPD) which addresses: epidemiology and causes, pathophysiology, exacerbations, systemic manifestations and comorbidities, clinical management.

Length of publication:  Web-page

Some important notes: Original article is available with an NHS Athens username; please contact your local NHS Library for the full text of the article. Follow this link to find your local NHS Library.  

Acknowledgement: National electronic Library for Medicine

Thorax in focus: COPD

Source: Thorax  2012;67:171-176 doi:10.1136/thoraxjnl-2011-201231

Follow this link for the abstract

Date of publication: November 2011

Publication type: Journal article

In a nutshell: This article reviews original research published in the journal over the last 2-3 years. It considers scientific and clinical developments in the epidemiology, mechanisms and treatment of COPD.

Length of publication:  7 pages

Some important notes: Original article may be available with an NHS Athens username; contact your local NHS library service for details Follow this link to find your local NHS Library

GPs face huge gaps in COPD funding

Source:  GP Online

Follow this link for the full text

Date of publication: 16 November 2011

Publication type: News story

In a nutshell: News item reporting that “a lack of PCT investment in the ‘gold standard’ treatment for COPD is undermining patients’ quality of life and increasing practice workload”.

Length of publication: 1 web page

COPD uncovered

Source:  BMC Public Health 2011, 11:612doi:10.1186/1471-2458-11-612

Follow this link for the full text

Date of publication:  August 2011

Publication type:  Journal article

In a nutshell: This international survey on the impact of COPD on a working age population aimed to investigate the wider personal, economic and societal burden of the disease.  A cross-country [Brazil, China, Germany, Turkey, US, UK] cross-sectional survey methodology was used with 2426 participants aged 45-67.  The authors provide costs (in dollars and pounds) for the annual cost of healthcare utilisation and lost time from work for individuals.

Length of publication: 13 page pdf

Quality standard for chronic obstructive pulmonary disease

Source: NICE http://www.nice.org.uk

Follow this link for the abstract

Follow this link for the full-text

Date of publication: July 2011

Publication type: Strategy

In a nutshell: The quality standard and the Outcomes Strategy are complementary but serve different purposes. The quality standard provides a set of 13 clear statements describing high-quality care. It focuses on assessment, diagnosis and the treatment of diagnosed COPD. It is based on current NICE guidance and is consistent with the Outcomes Strategy for the areas it covers. The quality standard for chronic obstructive pulmonary disease (COPD) requires that services should be commissioned from and coordinated across all relevant agencies encompassing the whole COPD care pathway.

Length of publication:  32 pages

Building your Staff for the Future : new competence framework launched to help deliver quality, patient-centred respiratory care

Source: Skills for Health http://www.skillsforhealth.org.uk

Follow this link for the abstract

Follow this link for the full-text

Date of publication: June 2011

Publication type: Report

In a nutshell: Skills for Health, in collaboration with the Respiratory Programme in the Department of Health, has led on the development of a respiratory disease competence framework that describes the knowledge, skills and attitudes that are required to deliver patient centred respiratory care. The full-text link above has links to the main report and the framework, plus case studies.

Length of publication: 23 pages

Acknowledgement: NHS Networks

COPD in England: a comparison of expected, model-based prevalence and observed prevalence from general practice data

Source:  Journal of Public Health. 2011;33(1):108-116

Follow this link for the abstract

Date of publication: March 2011

Publication type: Journal article

In a nutshell: The autors had a hypothesis that the prevalence of COPD is underestimated. The study found that there was evidence of a ‘north–south’ divide, with both observed and modelled prevalence higher in the north. Underdiagnosis was more pronounced in urban areas.  So the inclusion of GP numbers in the analysis yielded a stronger regression relationship, suggesting primary care supply affects diagnosis.  An online resource based on the model is available at: http://www.apho.org.uk/resource/view.aspx?RID=48308. This contains pre-calculated COPD estimates for English local authorities and primary care trusts, based on post-October 2006 boundaries, with projections to 2020, and also GP practice level estimates.

Length of publication:  9 pages

Some important notes: Original article may be available with an NHS Athens username; contact your local NHS library service for details.  Follow this link to find your local NHS Library.

Community care assessment of exacerbations of chronic obstructive pulmonary disease

Source:  Journal of Advanced Nursing

Follow this link for the abstract

Date of publication: November 2010

Publication type: Journal article

In a nutshell: Found that the majority of chronic obstructive pulmonary disease exacerbations can be safely managed in a community setting, but clinical assessment alone may not be sufficient to identify all patients who will develop complications such as respiratory failure. Further research is needed to validate clinical assessment and
decision-making algorithms for community-management of chronic obstructive pulmonary disease exacerbations.

Length of publication:  10 pages

Some important notes: Original article may be available with an NHS Athens username; contact your local NHS library service for details.  Follow this link to find your local NHS Library.

Acknowledgement: Cinahl

Do spirometry and regular follow-up improve health outcomes in general practice patients with asthma or COPD?

Source: Medical Journal of Australia 2010; 193 (2): 104-109

Follow this link for the abstract and link to full text pdf

Date of publication: July 2010

Publication type: Journal article

In a nutshell: This cluster randomised controlled trial looked at spirometry with regular medical review for patients with asthma or chronic obstructive pulmonary disease (COPD) managed in general practice.
The authors conclude that three-monthly spirometry and regular medical reviews by GPs are not associated with any significant improvement in quality of life or other health outcomes for patients with asthma and/or COPD.

Length of publication:  6 pages

Acknowledgement: Mednar Alert

A simple case-management programme can improve outcomes in COPD

Source: American Journal of Respiratory and Critical Care Medicine, published early online 14 January 2010

Follow this link for the abstract

Follow this link for the full-text

Date of publication: published early online 14 January 2010

Publication type: Article

In a nutshell: This study aimed to determine whether an easily implemented programme that focussed on early recognition and self-treatment of exacerbations could improve outcomes in COPD patients. Participants were randomised to intervention and control groups, and followed for 12 months or death. The intervention comprised an education session lasting 1 to 1.5 hours, an action plan for self-treatment of exacerbations, and monthly follow-up telephone calls from a case manager. Control patients received usual care. The authors conclude that their relatively simple COPD disease management programme reduced hospitalisations and ED visits in this high-risk patient group by 41%.

Length of publication:  41 pages