Outcome of Nurse Based Review Using A Computer-Guided Consultation In COPD

92 patients were selected from 5 GP practices and nurse reviews were undertaken using the LungHealth COPD guided consultation. These are patients who already had an established diagnosis of COPD and were on the GP register with this diagnosis.

What did the study report?

Use of the COPD guided consultation resulted in the finding that a significant proportion of patients labelled with COPD on primary care GP registers did not actually have the diagnosis.  Furthermore, the nurse users all agreed that the use of the COPD guided consultation improved patient outcomes and yet gaining competency in its use was not challenging for the operator. 

How accurate was the diagnosis of COPD? 18.6% of the sample had normal spirometry and therefore did not have COPD and were thus removed from the COPD register (McNemar's test; p<0.001)

Grading the severity of COPD: Prior to the implementation of the guided consultation, only 29% of the sample had been classified according to the severity of COPD which is mandatory during each review. (McNemar's test; p=0.032)

What did the users think of the system? There was significant agreement on the following points:

• Use of the LungHealth guided consultation standardised patient care

• No part of the assessment was omitted using the software.

• The software aids in accurate diagnosis of COPD

• Only a minimum level of training (1-2 days) was required in order to gain competency in the use of the softwareR.M. Angus, A. Trusdale, L. Davies, E. McKnight, C. Hodgson, E. Thompson, M.G. Pearson. Am J Respir Crit Care Med 183;2011: A1499.

Read the abstract here.