Optimum Patient Care (OPC) and the Observational and Pragmatic Research Institute (OPRI) today announced the results of the latest UK observational study for the Collaboration on Quality Improvement Initiative for Achieving Excellence in Standards of Chronic Obstructive Pulmonary Disease (COPD) care (CONQUEST), which is being conducted in collaboration with AstraZeneca.
Focused on UK primary care, the study demonstrated key areas to enhance care for exacerbating COPD patients to minimise the risk of future cardiopulmonary events, including earlier diagnosis and increased patient monitoring and risk assessment.
To highlight such opportunities, the analysis assessed data from the Optimum Patient Care Research Database, containing >30-years of data, and records from >17 million patients. Using this unique resource, OPRI explored the clinical management of high-risk* COPD patients between 2000-2019, compared to national, global and CONQUEST Quality Standards.
4 Top Areas of Opportunity
1. Earlier Identification of COPD in Patients Experiencing Respiratory Flare-ups Pre-Diagnosis
35% of patients experienced ≥2 moderate or ≥1 severe exacerbations many years prior to receiving a diagnosis of COPD.
The scope for earlier identification (up to 10-years before diagnosis) remains unchanged from that reported by the OPRI group almost a decade ago.
2. Conducting Cardiac Risk Assessment in COPD Patients Experiencing Exacerbations** who are at High-Risk of Myocardial Infarction and other Cardiac Events
Scope to conduct cardiac risk assessment in >80% of both newly and already diagnosed high-risk patients.
3. Optimisation of Treatment in Patients with High-risk COPD
Opportunity to optimise medication management for the 45% of newly diagnosed patients who had no record of a COPD medication review within 6 months of treatment initiation or change.
4. Pulmonary Rehabilitation Referral for Symptomatic Diagnosed Patients
Scope to offer or refer 66% of newly diagnosed patients to pulmonary rehabilitation.
Pulmonary rehabilitation is one of the most effective interventions in COPD to improve symptoms and health related quality of life.
‘‘Our findings highlight clear opportunities for earlier intervention in UK primary care for patients with high-risk COPD’’, explained Professor David Price. ‘‘CONQUEST addresses these areas, and goes one step further, by automating processes for physicians, to ensure early diagnosis, cardiopulmonary risk assessment and adequate treatment become the standard of care’’, added OPRI’s founder and CEO.
Identifying and acknowledging this scope for improving COPD management presents major opportunities to influence patient outcomes in UK primary care. Given the pressures imposed on primary care by the COVID-19 pandemic, it is likely there is now even greater potential for change in assessment and treatment of these high-risk patients.
Vice President of Medical, Respiratory & Immunology for AstraZeneca, Robert Fogel, remarked “At AstraZeneca, we are committed to addressing the vast patient and systemic burden of COPD with a goal of cutting the exacerbation rate in half by 2030 and reducing the associated cardiopulmonary mortality risk. To achieve this, we need strong partnerships with the scientific community, like the one we have through CONQUEST, to help establish and implement quality standards to improve outcomes for patients at high risk due to COPD.”
To view the full results of CONQUEST’s UK Opportunity Analysis study and the scope for change, read the paper in The Lancet Regional Health - Europe.
*High-risk: patients with ≥2 moderate or ≥1 severe (requiring hospitalization) exacerbations in the previous 12 months.
** COPD exacerbations are a major healthcare burden in COPD, and carry considerable consequences, including lung function decline, cardiac events, and steroid-related side effects.
CONQUEST is a collaborative, interventional COPD registry that drives long-term, targeted, patient-centred changes in COPD management. The promotion of expert and guideline-led care aims to reduce exacerbation frequency and improve health care outcomes. It comprises an integrated quality improvement program focusing on patients (diagnosed and undiagnosed) at a modifiable and higher risk of COPD exacerbations. CONQUEST is underpinned by four evidence-based Quality Standards developed by 11 experts internationally recognized in their field. CONQUEST is co-funded by AstraZeneca and OPC.