COPD services in primary care vary widely across UK– new study

Wales is leading the way across the UK in referring people with chronic lung disease for vital exercise and education programmes (pulmonary rehabilitation) which can be key to their quality of life - according to a new study presented at the British Thoracic Society (BTS) Winter Meeting today (Friday 6th December 2019).

The research authors will tell delegates, however, that the overall picture is mixed with some positives and some deficiencies in most UK countries in delivering aspects of COPD care. 

The new study led by Philip Stone, a researcher from Imperial College London, analysed the differences in NHS primary care services for Chronic Obstructive Pulmonary Disease (COPD) patients in England, Scotland and Northern Ireland compared with Wales.   

The research revealed that you are approximately twice as likely to get a referral for pulmonary rehabilitation in Wales than in England or Scotland. Other data showed that you’re at least twice as likely to have key tests to confirm airways obstruction in Wales than in England, Scotland, or Northern Ireland, but improvement is required across all countries.

Northern Ireland topped the data table on the likelihood of providing stop smoking support, with English and Scottish patients less likely to receive treatment.

Philip Stone, study lead and researcher from Imperial College London, said:

“There are differences across all UK countries in their management of COPD in primary care. 

"All countries need to improve their testing to confirm airways obstruction, as even the best performing nation, Wales, still only completed it in less than 15% of patients. However, on a positive note, Wales seems to be excelling at referring suitable patients to pulmonary rehabilitation. This may be due to the nation having a national respiratory strategy and audit in place for some time now.”

The study (created by Imperial College London) used data from the Clinical Practice Research Datalink (CPRD), which captures care across the whole of the UK, and compared that to Welsh primary care data captured by the National COPD Audit Programme. The first step was to confirm that the two sets of data were comparable by producing a COPD cohort for the period 01/04/2015 to 31/03/2017 using the CPRD. While the CPRD only contains current data for approximately 3% of the UK’s primary care providers, the data are representative of the whole country, and the final analysed cohort included over 56,000 COPD patients.

Professor Jon Bennett, Consultant Respiratory Physician and Chair of the British Thoracic Society’s Board, said:

 “This study shows a mixed picture in the provision of primary care services for COPD patients across countries in the UK. There is certainly some encouraging progress – but definitely room for improvement.   

"We need to learn from best practice and each other to enable greater provision of evidence-based and highly effective treatments that can improve quality of life – such as smoking cessation and pulmonary rehabilitation.

"The study, however, does demonstrate the benefits of the Welsh national respiratory strategy and audit for COPD care being in place for some time. But given that other UK countries now have, or are investing further in, national lung strategies and plans - the outlook for COPD diagnosis and care across the UK could well be more positive in the future.”  

Chronic obstructive pulmonary disease (COPD) is the name for a group of lung conditions that cause breathing difficulties. It includes both emphysema and chronic bronchitis. An estimated 1.2 million people are living with diagnosed COPD in the UK.

ENDS

For more information prior to the British Thoracic Society Winter Meeting (i.e. before Wednesday 4th December 2019):

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During the British Thoracic Society meeting (from Wednesday 4th to Friday 6th December 2019):

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Note to Editors:

The British Thoracic Society is the UK’s professional body of respiratory specialists. The Society seeks to improve standards of care for people who have respiratory diseases and to support and develop those who provide that care.  A registered charity, it has about 3,700 members including doctors, nurses, respiratory physiotherapists, scientists and other professionals with a respiratory interest.

The British Thoracic Society Winter Meeting takes place between 4-6 December 2019 at the Queen Elizabeth II Conference Centre in Westminster, London.