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Associations with post-consultation health-status in primary care managed acute exacerbation of COPD

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journal contribution
posted on 15.03.2022, 15:55 authored by David Gillespie, Nick Francis, Haroon Ahmed, Kerenza Hood, Carl Llor, Patrick White, Emma Thomas-Jones, Helen Stanton, Bernadette Sewell, Rhiannon PhillipsRhiannon Phillips, Gurudutt Naik, Hasse Melbye, Rachel Lowe, Nigel Kirby, Ann Cochrane, Janine Bates, Mohammed Fasihul Alam, Christopher Butler
Background: It has been demonstrated that antibiotic prescribing for Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) can be safely reduced in primary care when general practitioners have access to C-reactive protein (CRP) rapid testing.
Aim: To investigate the factors associated with post-consultation COPD health status in patients presenting with AECOPD in this setting.
Design and Setting: A cohort study of patients enrolled in a randomised controlled trial. Patients aged 40+ years with a clinical diagnosis of COPD who presented in primary care across England and Wales with an AECOPD were included.
Methods: Participants were contacted for follow-up at one- and two-weeks by phone and attended the practice four weeks after the index consultation. The outcome of interest was the Clinical COPD Questionnaire (CCQ) score. Multivariable multilevel linear regression models fitted to examine the factors associated with COPD health status in the four-weeks following consultation for an AECOPD.
Results: A total of 649 patients were included, with 1947 CCQ total scores analysed. Post-consultation CCQ total scores were significantly higher (worse) in participants with diabetes (adjusted mean difference [AMD]=0.26; 95% confidence interval (CI) 0.08– 0.45), obese patients compared to those with normal body mass index (AMD = 0.25, 95% CI 0.07– 0.43), and those who were prescribed oral antibiotics in the prior 12 months (AMD = 0.26; 95% CI 0.11– 0.41), but only the two latter associations remained after adjusting for other sociodemographic variables.
Conclusion: COPD health status was worse in the four weeks following primary care consultation for AECOPD in patients with obesity and those prescribed oral antibiotics in the preceding year.

History

Published in

International Journal of Chronic Obstructive Pulmonary Disease

Publisher

Dove Press

Version

VoR (Version of Record)

Citation

Gillespie, D., Francis, N., Ahmed, H., Hood, K., Llor, C., White, P., Thomas-Jones, E., Stanton, H., Sewell, B., Phillips, R, Naik, G.et al (2022). 'Associations with Post-Consultation Health-Status in Primary Care Managed Acute Exacerbation of COPD', International Journal of Chronic Obstructive Pulmonary Disease, 17, pp.383-394.

Electronic ISSN

1178-2005

Cardiff Met Affiliation

Cardiff School of Sport and Health Sciences

Cardiff Met Authors

Rhiannon Phillips

Cardiff Met Research Centre/Group

  • Public Health and Wellbeing

Copyright Holder

© The Authors

Language

en