Chronic obstructive pulmonary disease in a Portuguese Primary Health Care Unit: a quality improvement study

Liliana Jesus, Ana Raquel Pereira, Ana Quelhas, Ana Margarida Alves

Keywords: Pulmonary Disease, Chronic Obstructive; Quality Improvement

Background:

The prevalence of chronic obstructive pulmonary disease (COPD) is 14.2% in people over 40, increasing with age and smoking in both genders, and is the sixth leading cause of preventable death. However, because several determinants of respiratory health are socio-economic in nature and therefore difficult to address, chronic respiratory diseases have been relegated to the background.

Research questions:

What is the quality of care for patients with COPD at the Terras de Santa Maria Health Unit?

Method:

Observational and retrospective study with the aim of improving and assuring the quality of care. Study Unit: Patients with COPD from the Terras de Santa Maria Health Unit; Timeframe: January 2022 to December 2024. The following criteria were analysed: administrative data completion; COPD-related face-to-face medical consultation; COPD-related face-to-face nursing consultation; smoking status; smoking intervention; vaccination status.

Results:

In the preliminary analysis for the period from January to December 2022, we found 153 COPD patients. 70.6% and 81.0% of them had COPD-related medical and nursing consultations, respectively. Of those seen by a medical professional, 19.3% were smokers, and 72% of them were advised to stop smoking. Among the patients with a nursing assessment, 14.5% are smokers, and an intervention related to smoking was carried out in 83.3% of them. 77.1% of patients with COPD were vaccinated against seasonal influenza. Only 23.5% were fully vaccinated against pneumococcal disease. The proportion of COPD patients with FEV1 recorded in the last 3 years was 57.51%.

Conclusions:

The authors believe there is room for improvement in the care of patients with COPD. Training for the multi-professional team on diagnosis, management, treatment and inhaler devices and technique was provided between March and June 2023. A multi-professional consultation on chronic respiratory pathology has been developed and a new mid-term evaluation is proposed for data from August to December 2023, following the implementation of this consultation.

Points for discussion:

Multi-professional consultation on chronic respiratory pathology organization

Chronic respiratory diseases diagnosis and management training

Defined quality of care targets/goals

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