Management of COPD in primary care in Leicestershire

Abstract

Chronic Obstructive Airways Disease (COPD) is a common treatable condition suitable for primary care given certain prerequisites. These are disease specific registers, protocols and clinics and access to quality assured spirometry for accurate diagnosis and monitoring of disease progression. To determine proportion of practices with COPD registers, protocols and clinics and the resources to provide high quality spirometry. A postal survey of the identified lead respiratory nurse and doctor in 147 Leicestershire practices. Reminders were sent after six weeks of non-response. Further telephone questionnaires were sent to non-responders after twelve weeks. The response rate was 61%. 43 (49%) responding practices had COPD protocols, 49 (54%) practices had COPD registers and 8 (9%) practices had COPD clinics. 50 (56%) practices owned one or more spirometers and 13 (15%) had at least 1 person with current (within the last 2 years) approved/formal training in performing spirometry. Only 4 (4%) of practices had COPD protocols, registers and clinics and trained operators with current training. Very few practices in Leicestershire have the prerequisites to provide high quality of primary care of COPD. Maintenance of current approved training for spirometry operator is likely to be a major continuing barrier to providing high quality practice based primary care of COPD. This may be best provided at a locality level by intermediate care.