Medical Care According to Risk Level and Adaptation to Spanish COPD Guidelines (GesEPOC): The Epoconsul Study

Abstract

IntroductionEPOCONSUL is the first national audit to analyze medical care for COPD in pulmonology departments in Spain. The main objective was to perform a retrospective analysis to determine the distribution of GesEPOC 2017 COPD risk levels and to evaluate management according to the new recommendations. Material and methodsThis is a cross-sectional clinical audit in which consecutive COPD cases were recruited over one year. The study evaluated risk and clinical phenotype according to GesEPOC 2017, and their correlation with the clinical interventions employed. ResultsThe most common risk category was high risk (79.8% versus 20.2%; P<.001), characterized by a higher level of severity on BODE and BODEx indexes, and a higher comorbidity burden. The most common phenotype was non-exacerbator. The most commonly used treatment in low-risk patients was bronchodilator monotherapy (34.8%) and triple therapy in high-risk patients (53.7%). Patients with high risk were more requently classified according to their phenotype (57.6% versus 52%; P=.014) and had more frequently recorded pulmonary function tests: lung volume (47.7% versus 35.8%; P<.001), lung diffusion (51.4% versus 42.1%; P<.001) and walk test (37.8% versus 15.8%; P<.001). ConclusionsMost patients treated in pulmonology departments were high-risk and non-exacerbator phenotype. Clinical interventions differed according to risk level and mainly followed GesEPOC recommendations, although there is significant room for improvement.