Advertisement

Patient Factors Influencing Respiratory-Related Clinician Actions in Chronic Obstructive Pulmonary Disease Screening

Published:September 09, 2016DOI:https://doi.org/10.1016/j.amepre.2016.07.015

      Introduction

      The purpose of this study was to identify patient-related factors that may explain the increased likelihood of receiving a respiratory-related clinician action in patients identified to be at risk for chronic obstructive pulmonary disease in a U.S.-based pragmatic study of chronic obstructive pulmonary disease screening.

      Methods

      This post hoc analysis (conducted in 2014–2015) of the Screening, Evaluating and Assessing Rate Changes of Diagnosing Respiratory Conditions in Primary Care 1 (SEARCH1) study (conducted in 2010–2011), used the chronic obstructive pulmonary disease Population Screener questionnaire in 112 primary care practices. Anyone with a previous chronic obstructive pulmonary disease diagnosis was excluded. Multivariate logistic regression modeling was used to assess patient factors associated with the likelihood of receiving an respiratory-related clinician action following positive screening.

      Results

      Overall, 994 of 6,497 (15%) screened positive and were considered at risk for chronic obstructive pulmonary disease. However, only 187 of the 994 patients (19%) who screened positive received a respiratory-related clinician action. The chances of receiving a respiratory-related clinician action were significantly increased in patients who visited their physician with a respiratory issue (p<0.05) or had already been prescribed a respiratory medication (p<0.05). Most (81%) patients who screened positive or had a respiratory-related clinician action had one or more comorbidity, including cardiovascular disease (68%), diabetes (30%), depression/anxiety (26%), asthma (11%), and cancer (9%).

      Conclusions

      Routine chronic obstructive pulmonary disease screening appears to promote respiratory-related clinician actions in patients with a high likelihood for disease who have respiratory complaints or already use prescribed respiratory medication.
      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to American Journal of Preventive Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Global Initiative for Chronic Obstructive Lung Disease
        Global Strategy for the Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease.
        Global Initiative for Chronic Obstructive Lung Disease. 2015;
      1. National Institutes of Health. Chronic Obstructive Pulmonary Disease (COPD) Fact Sheet. October 2010. http://report.nih.gov/nihfactsheets/Pdfs/ChronicObstructivePulmonaryDisease(NHLBI).pdf. Accessed December 17, 2015.

        • Celli B.R.
        • Thomas N.E.
        • Anderson J.A.
        • et al.
        Effect of pharmacotherapy on rate of decline of lung function in chronic obstructive pulmonary disease: results from the TORCH study.
        Am J Respir Crit Care Med. 2008; 178: 332-338https://doi.org/10.1164/rccm.200712-1869OC
        • Tashkin D.P.
        • Celli B.
        • Senn S.
        • et al.
        A 4-year trial of tiotropium in chronic obstructive pulmonary disease.
        N Engl J Med. 2008; 359: 1543-1554https://doi.org/10.1056/NEJMoa0805800
        • Yawn B.P.
        • Duvall K.
        • Peabody J.
        • et al.
        The impact of screening tools on diagnosis of chronic obstructive pulmonary disease in primary care.
        Am J Prev Med. 2014; 47: 563-575https://doi.org/10.1016/j.amepre.2014.07.030
        • Martinez F.J.
        • Raczek A.E.
        • Seifer F.D.
        • et al.
        Development and initial validation of a self-scored COPD Population Screener Questionnaire (COPD-PS).
        COPD. 2008; 5: 85-95https://doi.org/10.1080/15412550801940721
        • Joo M.J.
        • Lee T.A.
        • Weiss K.B.
        Geographic variation of spirometry use in newly diagnosed COPD.
        Chest. 2008; 134: 38-45https://doi.org/10.1378/chest.08-0013
        • Lee T.A.
        • Bartle B.
        • Weiss K.B.
        Spirometry use in clinical practice following diagnosis of COPD.
        Chest. 2006; 129: 1509-1515https://doi.org/10.1378/chest.129.6.1509
        • Mapel D.W.
        • Picchi M.A.
        • Hurley J.S.
        • et al.
        Utilization in COPD: patient characteristics and diagnostic evaluation.
        Chest. 2000; 117 (346S-353S)https://doi.org/10.1378/chest.117.5_suppl_2.346S
        • Han M.K.
        • Kim M.G.
        • Mardon R.
        • et al.
        Spirometry utilization for COPD: how do we measure up?.
        Chest. 2007; 132: 403-409https://doi.org/10.1378/chest.06-2846
        • Carlin B.W.
        COPD and associated comorbidities: a review of current diagnosis and treatment.
        Postgrad Med. 2012; 124: 225-240https://doi.org/10.3810/pgm.2012.07.2582
        • García-Olmos L.
        • Alberquilla A.
        • Ayala V.
        • et al.
        Comorbidity in patients with chronic obstructive pulmonary disease in family practice: a cross sectional study.
        BMC Fam Pract. 2013; 14: 11https://doi.org/10.1186/1471-2296-14-11
        • Sievi N.A.
        • Senn O.
        • Brack T.
        • et al.
        Impact of comorbidities on physical activity in COPD.
        Respirology. 2015; 20: 413-418https://doi.org/10.1111/resp.12456
        • Hillas G.
        • Perlikos F.
        • Tsiligianni I.
        • Tzanakis N.
        Managing comorbidities in COPD.
        Int J Chron Obstruct Pulmon Dis. 2015; 10: 95-109
        • Siu A.L.
        • Bibbins-Domingo K.
        • et al.
        • U.S. Preventive Services Task Force
        Screening for chronic obstructive pulmonary disease: U.S. Preventive Services Task Force Recommendation Statement.
        JAMA. 2016; 315: 1372-1377https://doi.org/10.1001/jama.2016.2638