COPD Management in Primary Care: Underutilisation of Nursing Consultations.
Marc Vila, Meritxell Mondejar, Sergio Cazorla-Calderón and 4 others
PMID 41678226WHAT IT FOUND
Many patients recorded as having COPD in primary care lacked spirometry confirmation, and dyspnea or inhaler adherence was often missing.
A COPD label may not mean the diagnosis is confirmed or care is documented.
Key findings
01Only 1.7% of the 28,000 people assigned to the three primary care centres were recorded as having COPD, and spirometry was available for 154 patients pre-bronchodilator and 189 post-bronchodilator.
02Key follow-up variables were often missing: dyspnea was recorded in 20% of women and 16% of men, and inhaler adherence was recorded in 28.5% of each sex group.
03Nursing visits were higher in patients with COPD plus cardiovascular disease and diabetes (4.71 ± 4.87) than in patients with COPD alone (1.84 ± 5.27).
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
The study looked back at routine electronic records, so missing structured fields may mean data were not recorded, not that care was not given. Part of the information may have been free text and could not be retrieved automatically. Spirometry was available in only a subset, so severity findings apply only to those with recorded spirometry. Analyses were descriptive and did not adjust for confounders or correct for multiple comparisons, so associations cannot be read as causal. Some subgroups were small, reducing statistical power. Previous COPD exacerbation hospitalisations were not captured.
Declared interests
The study was funded by Instituto de Salud Carlos III under project PM21/00090. Authors declare no conflicts of interest.
The easy way to misread this
Do not read the 1.7% label rate as the true COPD prevalence. Many structured fields were missing, and spirometry was recorded for only 154 patients pre-bronchodilator and 189 post-bronchodilator.