Abstract

Background:
Those living in the most deprived sectors of society are most effected by chronic lung diseases. The NIHR Deep End Clinical Research Network comprises of General Practices in the most deprived areas of Sheffield. These patient populations are likely to experience the greatest burden of chronic lung disease.

Aim: To map the landscape (prevalence, risk factors and interventions) for patients with chronic lung disease registered in Deep End General Practices in Sheffield to identify priority areas for future research.

Method:
Seven Deep End Practices consented to inclusion in this project (67300 patients). All but one practice had a higher than average (13%) proportion of patients from ethnic minority groups, median 49.3% (IQR38,52) (Table 1). Data were extracted (April-July 2020) through code searching EMIS and SytmOne, no date restrictions were applied. Codes encompassed chronic lung diseases of interest, risk factors and interventions. Data analysis was performed in R 4.1.0.

Result:
Deep End Practices had significantly higher proportions of smokers, median 31.7% (IQR 30.5, 36.0) than the national average, 14%. The proportion of patients diagnosed with chronic obstructive pulmonary disease (COPD), median 2.72% (IQR 2.4,3.5), was slightly higher than the national average, 2%. (Figure 1) In those diagnosed with COPD a median of 12.8% (IQR8.7,15.8) had commenced pulmonary rehabilitation with a median of 47% (IQR41.6,74.1) declining. The proportion of patients with COPD receiving seasonal influenza vaccination was a median of 60.8% (IQR58.6,62.8). Those receiving pneumococcal vaccination was lower, median 24.4% (IQR19.6,36). Low pneumococcal vaccination uptake was seen in patients with asthma and bronchiectasis.

Conclusion:
Deep End Practices experience a high burden of chronic lung disease. In those that are identified, best practice evidence-based treatments such as pulmonary rehabilitation and vaccination are failing to reach them.