Exploring the impact of integrated COPD care in general practice

Patel, Ketan ORCID: 0000-0002-1313-6252 (2023). Exploring the impact of integrated COPD care in general practice. University of Birmingham. M.D.

Preview

Patel2023MD.pdf
Text - Accepted Version
Available under License All rights reserved.
Download (2MB) | Preview

Abstract

Integrated care is an umbrella term used to describe collaboration across differing healthcare sectors. Integrated care interventions directed towards patients with Chronic Obstructive Pulmonary Disease (COPD) in primary care have been shown to improve patient outcomes, such as quality of life. However, the utilisation of integrated care interventions to improve guideline adherence and reduce the prevalence of COPD misdiagnosis in primary care has not been explored previously.

The mixed methods systematic review demonstrated that misdiagnosis of COPD does occur in primary care and is predominantly due to difficulties utilising spirometry and differentiating COPD from asthma. Integrated care interventions utilising specialist led spirometry were shown to be able to identify misdiagnosed patients and were perceived to be able to reduce the prevalence of COPD misdiagnosis in primary care.

The impact of integrating COPD specialists into GP practices was evaluated through a pragmatic cluster randomised controlled trial (INTEGR COPD). The integration of COPD specialists led to significant improvements in the delivery of guideline adherent care, which was shown to correlate with improvements in quality of life. Integrating COPD specialists into GP practice also led to misdiagnosed patients being identified and having their diagnosis and treatment corrected.

The integration of COPD specialists into GP practices was found to be acceptable to patients and healthcare professionals. The reluctance to challenge historic diagnoses was thought to be the underlying cause of patients remaining misdiagnosed in primary, within this cohort. Specialist involvement was deemed to have a positive impact in reducing the extent of COPD misdiagnosis in primary care.

The findings from this thesis suggest that integrated COPD care has a positive impact on the delivery of optimal patient care as well as the prevalence of COPD misdiagnosis in GP practices.

Type of Work:

Thesis (Doctorates > M.D.)

Award Type:

Doctorates > M.D.

Supervisor(s):