The quality of COPD care in German general practice—A cross-sectional study

Abstract

Objectives: Chronic Obstructive Pulmonary Disease (COPD) is a common health problem to be dealt with in primary care. Little is known about the quality of care provided for patients with COPD in Germany. Therefore, we wanted to assess the current quality of care delivered by a primary care network (PCN) for patients with COPD. Methods: A cross-sectional study was conducted in collaboration with a primary care network (PCN). All patients of the PCN aged 40 years and older with a diagnosis of COPD were identified through electronic health records (EHR). A set of quality indicators (QIs) developed in accordance with current COPD-guidelines were appraised through numerical data retrieved from the EHR. Results: In total, 2,568 patients with COPD were identified. Their mean age was 67 (SD±12) years, 49% were male. Thirty-five percent had a parallel diagnosis of asthma. There was no documentation of any spirometry for 54% of patients; 29% had a spirometry within the previous year. An influenza vaccination was documented for 37% within the preceding 12 months; 12% received a pneumococcal vaccination in the last 6 years. Smoking status was documented for 44% within the last year. Conclusion: The quality of care for patients with COPD in the PCN seemed suboptimal, despite the presence of a Disease Management Program (DMP). This finding is likely to apply widely to German general practice. Quality assessment through currently available EHR data was challenging due to non-standardized and insufficient documentation.

Prevalence of Spirometry Testing among Patients with Asthma and COPD in German General Practices

“…Burkhardt and Pankow reported that 80% of primary care physicians’ offices in Germany were equipped with spirometers [ 6 ]. At the same time, Heinmüller et al reported that, for Germany in 2020, of 2568 patients with COPD, 29% had had a spirometry test within the previous year [ 7 ].…”

Investigating primary healthcare practitioners’ barriers and enablers to referral of patients with COPD to pulmonary rehabilitation: a mixed-methods study using the Theoretical Domains Framework

“…While this paper highlights multiple barriers in referring patients with COPD to PR, barriers to high-quality healthcare for patients with COPD span throughout the disease trajectory and persist across health service provisions worldwide 40–42. It is interesting to note that few participants in our study thought that a financial incentive was important.…”

“…While this paper highlights multiple barriers in referring patients with COPD to PR, barriers to high-quality healthcare for patients with COPD span throughout the disease Open access trajectory and persist across health service provisions worldwide. [40][41][42] It is interesting to note that few participants in our study thought that a financial incentive was important. It is however difficult to assess this given that face-to-face PR programmes were suspended across the country as a result of the COVID-19 pandemic.…”

Documentation of the patient’s smoking status in common chronic diseases – analysis of medical narrative reports using the ULMFiT based text classification

“…It is possible that documentation of smoking is most often missed when the patient does not smoke, since then no intervention is needed. Prior studies have reported that 44–95% of patients with asthma, COPD or diabetes have a smoking status documented in primary care EHR [ 21–24 ]. Studies in secondary health care are scarce.…”