Real Life use of a Computer-Guided Consultation in COPD

The study reports the results of the implementation of the LungHealth COPD guided consultation in 417 patients across 13 General Practices and whether key guideline standards central to the guide consultation had been followed and met prior to its use. 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? 

The implementation of the LungHealth COPD guided consultation enables key guideline-based standards to be met when diagnosing and reviewing COPD patients within primary care.

Establishing a diagnosis of COPD: The findings were that when all 417 patients underwent spirometry as part of the LungHealth COPD review, 18% of this group were found not to have the diagnosis of COPD based on results of spirometry (McNemar's test; p<0.001

Having a personalised action plan to manage COPD: 87% of the patients should have had a personalised written educational action plan for their COPD as part of their review prior to implementation of the software and yet had not undergone this (McNemar's test; p<0.001) with a further 59.5% not having a crisis management plan (McNemar's test; p<0.001) and these were implemented following review with the LungHealth guided consultation. 

Checking proper inhaler technique: The implementation of the software resulted in the inhaler technique being found deficient in 9.2% of patients which should have been discovered prior to this review (McNemar's test; p<0.001). 

Smoking Cessation: The implementation of the software resulted in 18% of the sample being referred to smoking cessation services and this had not been done prior to the implementation yet should have been done (McNemar's test; p<0.001).

E. B. Thompson, M. G. Pearson, L. Davies, E. McKnight, A. Trusdale, K. Sargeant, R. M. Angus.. Am J Respir Crit Care Med 2013;187: A2829

Read the abstract here.