Management of chronic obstructive pulmonary disease in general practice in denmark

INTRODUCTION: In recent years, increased awareness and focus on chronic obstructive pulmonary disease (COPD) has evolved. Alongside, a growing interest has emerged in quality of care including early diagnosis, smoking cessation, rehabilitation and relevant medication as tools for achieving a better prognosis. METHODS: The aim of this study was to analyse the quality of real-life management of COPD in a representative sample of Danish general practices. Our main focus was to measure the fulfilment of ten specific quality-of-care indicators at the annual control visit for management of COPD, as suggested by the Danish Society of General Practitioners (DSAM), by extracting relevant data from the electronic patient medical records (PMR) of the general practitioners’ (GP) electronic patient filing systems. RESULTS: In total, 82 GP clinics participated in the study. Approximately half were solo clinics and the rest were various types of partnership clinics. The records of 1,556 COPD patients (51.3% males) with an average age of 69.7 years (range: 36-97 years) were included. We found the level of registration of the quality-of-care standards to be very low, as only 11.1% (95% confidence interval: 7.9-15.8%) of the PMR recorded an acceptable (80-99%) or excellent (100%) registration. CONCLUSIONS: Improvement of adherence to COPD guidelines among GPs is of paramount importance to improve management and reduce the overall burden of COPD. However, this study demonstrates that substantial room for improvement remains.