Management of Patients With Chronic Obstructive Pulmonary Disease in Granada: a Clinical Audit

Study Overview
=================
Brief Summary
-----------------
It is actually unknown how are the COPD clinical guidelines followed in primary care in Andalusia, specially for diagnosis and follow up of patients with this diseases. Detection of areas for improvement in COPD healthcare can be useful in order to implement improvement programs. This project is a clinical audit among primary care centres in Granada attending patients with COPD in the public health system

Detailed Description
-----------------
The aim of this study is to audit the attention to people with COPD among primary care centres in Granada, as well as how clinical guidelines are followed and other recommendations. The study will comprise medical records from more than 3000 patients.

Official Title
-----------------
Management of Patients With Chronic Obstructive Pulmonary Disease in Granada: a Clinical Audit

Conditions
-----------------
COPD

Intervention / Treatment
-----------------
* Other: Audit


Participation Criteria
=================
Eligibility Criteria
-----------------
Inclusion Criteria: Adults (men or women) aged more than 40 years old Diagnostic code in Andalusian clinical records (Diraya) in accordance with ICD-9 (Diagnostic codes 496, 492.8, 494.0, 491.20, 493.2) Current of former smokers of at least 10 pack- years Patient with a minimum follow up of 1 year, who have been assisted in a scheduled primary care appointment at inclusion date. Exclusion Criteria: Patients with a diagnostic code for COPD attended at primary care office, but without information related with COPD in the previous year. Patients currently involved in any clinical trial or research study related with COPD. Those patients excluded will be collected in an exclusion causes chart for each centre. These patients will not affect overall number of patients targeted for each centre.

Ages Eligible for Study
-----------------
Minimum Age: 40 Years

Sexes Eligible for Study
-----------------
All

Accepts Healthy Volunteers
-----------------
No

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| COPD patients<br>Adults (men or women) aged more than 40 years old Diagnostic code in Andalusian clinical records (Diraya) in accordance with ICD-9 (Diagnostic codes 496, 492.8, 494.0, 491.20, 493.2) Current of former smokers of at least 10 pack- years Patient with a minimum follow up of 1 year, who have been assisted in a scheduled primary care appointment at inclusion date. | Other: Audit<br>* Audit from clinical records<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To audit public healthcare for patients with COPD in primary care offices in Granada. | Number of patients with a diagnosis code for COPD among participants with auitable clinical records | 1 year | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| To describe clinical profile of patients with COPD attended at primary care offices in Granada | Number of patients auditable with a diagnosis code for COPD attended at primary care center | 1 year | 
| To describe the quality of care for COPD patients, focusing on determinants of variability(such as seasonality) | Pproportion of patients receiving correct diagnosis for COPD based on spirometric measurements | 1 year | 
| To evaluate the adherence to clinical guidelines for COPD | Proportion of patients with COPD with correct diagnosis according to GesEPOC guidelines. | 1 year | 
| To describe current available resources for COPD healthcare in the primary care level in Granada. | Number of centers with spirometry available | 1 year | 

 Terms related to the study
=================
Keywords Provided by Centre Hospitalier Valida
-----------------
COPD, Emphysema, Chronic Bronchitis, Clinical audit, Primary Healthcare