A computer guided consultation which delivers guideline-quality COPD reviews

This article provides an overview of the experience of the LungHealth Computer Guided Consultation (CGC) in practices over the last few years. Over 5000 patients have had a CGC review in more than 100 practices across the country. 

The findings in the various abstracts and paper described elsewhere have been consistent over time and even in the latest CCG to be analysed (Bedfordshire 2020) there is a mis-diagnosis rate of almost 20% of those studied.   This highly statistically significant difference (McNemar test: p<0.001) is due to the formal performance of spirometry and shows that 1 in 5 patients on the COPD register do not actually have COPD.   The CGC recommends discussion with the GP to consider alternative causes for the patients’ symptoms. In most of these patients, inhalers can be stopped.    

For those with confirmed COPD, the checks on other aspects of care – inhaler technique, written management plans, referral for smoking cessation, rehabilitation or oxygen assessments show that all are suboptimal and that the reminders lead to improvements in each.  The magnitude of change within a single CCG level is highly significant statistically (McNemar test: p<0.001) and has remained very similar over time – i.e as each new practice is added the findings are similar. Following the implementation of our software, 92% of patients had a written self-management plan in place compared to 44% before review and 12% were referred for smoking cessation support. There were also increases in pulmonary rehabilitation referrals.

Link to the article here: https://www.respiratoryfutures.org.uk/features/computer-guided-consultation-software-for-copd-reviews/