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Adherence to diagnostic guidelines and quality indicators in asthma and COPD in Swedish primary care.

Weidinger, Paolina LU ; Nilsson, J Lars G and Lindblad, Ulf LU (2009) In Pharmacoepidemiology and Drug Safety 18. p.393-400
Abstract
PURPOSE: To study the clinical evaluation and treatment of patients with asthma and COPD in primary care in Sweden, with a focus on adherence to recommended guidelines and quality indicators. METHODS: All visits at health care centres in Skaraborg, Sweden, are documented in computerized medical records constituting the Skaraborg Primary Care Database (SPCD). In a register-based retrospective observational study, all patients diagnosed with asthma or COPD during 2000-2005 (n = 12 328) were identified. In a 5% random sample (n = 623), information on performed investigations at initial visits and at follow-up during 2004-2005 was collected. Compliance with procedures as recommended by national guidelines was used for quality assessment.... (More)
PURPOSE: To study the clinical evaluation and treatment of patients with asthma and COPD in primary care in Sweden, with a focus on adherence to recommended guidelines and quality indicators. METHODS: All visits at health care centres in Skaraborg, Sweden, are documented in computerized medical records constituting the Skaraborg Primary Care Database (SPCD). In a register-based retrospective observational study, all patients diagnosed with asthma or COPD during 2000-2005 (n = 12 328) were identified. In a 5% random sample (n = 623), information on performed investigations at initial visits and at follow-up during 2004-2005 was collected. Compliance with procedures as recommended by national guidelines was used for quality assessment. RESULTS: Among 499 patients with asthma, 167 (33%) were investigated with spirometry or Peak Expiratory Flow (PEF) during initial visits in agreement with guidelines. Correspondingly, 40 out of 124 patients with COPD (32%) were investigated with spirometry. During follow-up, evaluation in agreement with guidelines was performed in 130 (60%) of patients with asthma and in 35 patients out of 77 (45%) with COPD. Prescribing of ICS reached quality target, still every second patient made an acute visit during follow-up. CONCLUSION: Adherence to recommended guidelines in asthma/COPD was low. Acute visits were common and despite the prescribing of ICS according to recommendations, patients still seem uncontrolled in their disease. There is a need for quality improvement in the clinical evaluation and treatment of patients with asthma and COPD. Copyright (c) 2009 John Wiley & Sons, Ltd. (Less)
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author
organization
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type
Contribution to journal
publication status
published
subject
in
Pharmacoepidemiology and Drug Safety
volume
18
pages
393 - 400
publisher
John Wiley & Sons
external identifiers
  • wos:000265987100007
  • pmid:19288473
  • scopus:67649391357
ISSN
1053-8569
DOI
10.1002/pds.1734
language
English
LU publication?
yes
id
2b1a1208-0eb4-4a95-9140-496f35ca0098 (old id 1367791)
alternative location
http://www.ncbi.nlm.nih.gov/pubmed/19288473?dopt=Abstract
date added to LUP
2009-04-08 11:31:53
date last changed
2017-10-08 04:28:30
@article{2b1a1208-0eb4-4a95-9140-496f35ca0098,
  abstract     = {PURPOSE: To study the clinical evaluation and treatment of patients with asthma and COPD in primary care in Sweden, with a focus on adherence to recommended guidelines and quality indicators. METHODS: All visits at health care centres in Skaraborg, Sweden, are documented in computerized medical records constituting the Skaraborg Primary Care Database (SPCD). In a register-based retrospective observational study, all patients diagnosed with asthma or COPD during 2000-2005 (n = 12 328) were identified. In a 5% random sample (n = 623), information on performed investigations at initial visits and at follow-up during 2004-2005 was collected. Compliance with procedures as recommended by national guidelines was used for quality assessment. RESULTS: Among 499 patients with asthma, 167 (33%) were investigated with spirometry or Peak Expiratory Flow (PEF) during initial visits in agreement with guidelines. Correspondingly, 40 out of 124 patients with COPD (32%) were investigated with spirometry. During follow-up, evaluation in agreement with guidelines was performed in 130 (60%) of patients with asthma and in 35 patients out of 77 (45%) with COPD. Prescribing of ICS reached quality target, still every second patient made an acute visit during follow-up. CONCLUSION: Adherence to recommended guidelines in asthma/COPD was low. Acute visits were common and despite the prescribing of ICS according to recommendations, patients still seem uncontrolled in their disease. There is a need for quality improvement in the clinical evaluation and treatment of patients with asthma and COPD. Copyright (c) 2009 John Wiley & Sons, Ltd.},
  author       = {Weidinger, Paolina and Nilsson, J Lars G and Lindblad, Ulf},
  issn         = {1053-8569},
  language     = {eng},
  pages        = {393--400},
  publisher    = {John Wiley & Sons},
  series       = {Pharmacoepidemiology and Drug Safety},
  title        = {Adherence to diagnostic guidelines and quality indicators in asthma and COPD in Swedish primary care.},
  url          = {http://dx.doi.org/10.1002/pds.1734},
  volume       = {18},
  year         = {2009},
}