Impact of the British Thoracic Society chronic obstructive pulmonary disease guidelines on patients' health status, healthcare resource use and health-related quality of life

Abstract

British Thoracic Society (BTS) guidelines for chronic obstructive pulmonary disease (COPD) management are a consensus view and their impact on patients is unknown. To determine the impact of the BTS COPD guidelines on patients' health status, healthcare resource use and health-related quality of life (HRQL). This was an observational, parallel group, cluster-controlled study comparing patients who were managed in general practices according to BTS guidelines (active practices) or usual care (control practices). 13 active and 13 matched control practices participated in the study. Patients completed the St. George's Respiratory Questionnaire (SGRQ) and Short Form 36 (SF-36) at their screening visit and 12 months later during which time their airway function was measured. Healthcare resource use and drug utilisation data during the study period were also recorded. 279 and 230 patients from active and control practices respectively were eligible for analysis. No significant differences in airway function were detected between patients managed at active and control practices. There were no significant differences in healthcare resource use and disease-specific quality of life indicators as measured by the SGRQ. There were some significant differences in health status between patients managed at active practices compared with controls as measured by the SF-36. Patients managed in general practice according to BTS guidelines experienced minor improvements in health status. Treatment strategy had no detectable impact on patients' airway function and healthcare resource use.