Screen for COPD during annual reviews, say GP specialists

Patients with chronic diseases such as diabetes should be screened for COPD during their annual reviews, according to GP researchers.

The close monitoring of patients with existing conditions present an opportunity for earlier COPD identification (Photograph: SPL)
The close monitoring of patients with existing conditions present an opportunity for earlier COPD identification (Photograph: SPL)

A large DoH-backed UK study of almost 40,000 patients with COPD found a large proportion had been treated for conditions such as ischaemic heart disease and asthma in the two years prior to their initial COPD diagnosis.

The high prevalence led GP respiratory specialists to suggest that patients with a history of chronic illness should also be checked for COPD to improve detection of the disease.

Lead author and Norfolk GP Professor David Price of Aberdeen University presented the findings at the European Respiratory Society annual congress in Amsterdam on Monday. He said: 'These data confirm that active comorbidities are common at the time of COPD diagnosis.'

'The close monitoring of patients with existing conditions present an opportunity for earlier COPD identification and diagnosis.'

He suggested decision-support prompting on GP computer systems could flag up a patient with a past history of smoking and diabetes or ischaemic heart disease. These individuals could then undergo COPD screening to detect previously undetected COPD.

Researchers analysed 38,859 patient records from the General Practice and Optimum Patient Care research databases.

Patients aged over 40 years were included if they had received their first COPD Read code between 1990-2009. The findings show an average of 53.3% of patients had asthma over the 20 year span, although this fell from 71.1% to 29.7% over this period.

In the two years before they received a COPD diagnosis, 7.7% of patients consulted for ischaemic heart disease. During this time, 18.5% consulted, or were prescribed drugs for, gastroesophageal reflux disease (GERD) and 9.6% for diabetes.

The team also found that consultations for comorbidites prior to diagnosis rose over the course of the study period. Ischaemic heart disease leapt from 6.5% in 1990 to 11.5% in 2009. GERD went from 1.5% to 8.4% and diabetes from 4.4% to 12.5%.

Authors said the increase may be due to greater awareness and improved diagnosis of comorbidities among patients with COPD in recent years, potentially as a result of incentive schemes such as the QOF.

Professor Price said: 'Patients with COPD often die as a result of their comorbidities and not as a result of their COPD. It becomes very important to understand the comorbidities because this will help to quantify the extent of the disease burden of the patient with COPD.'

He concluded: 'These patients should be evaluated for COPD as part of their annual review.'

 

Have you registered with us yet?

Register now to enjoy more articles and free email bulletins

Register

Already registered?

Sign in

Follow Us:

Just published

Starting your career as a newly-qualified GP

Starting your career as a newly-qualified GP

Dr Patrice Baptiste describes how she developed a portfolio career as a newly-qualified...

Limited COVID-19 vaccine supply hampers GP efforts to ramp up rollout

Limited COVID-19 vaccine supply hampers GP efforts to ramp up rollout

Limited supplies of COVID-19 vaccine have forced GP-led vaccination sites to operate...

Increase cancer tests in primary care during pandemic, suggests NHS England

Increase cancer tests in primary care during pandemic, suggests NHS England

Local health systems should look to provide more cancer diagnostics in primary care...

Daily COVID-19 vaccinations drop below level required to hit February target

Daily COVID-19 vaccinations drop below level required to hit February target

Numbers of COVID-19 vaccinations administered per day have dipped below the number...

UK COVID-19 vaccination programme tracker

UK COVID-19 vaccination programme tracker

GPs across the UK are playing a leading role in the largest-ever NHS vaccination...

GPs raise alarm over low uptake of COVID-19 vaccine in BAME patients

GPs raise alarm over low uptake of COVID-19 vaccine in BAME patients

GPs across England have raised concerns over low uptake of COVID-19 vaccination among...