Service improvement project: Introducing heart failure screening at COPD annual reviews in primary care. (ID 463)
Broad Street Health Centre
Funding: There was no need for extra funding.
Abstract
Background:Heart failure (HF) is a common comorbidity in people with chronic obstructive pulmonary disease (COPD), with an estimated prevalence of HF comorbidity in patients with COPD up to 40%. COPD and HF have overlapping symptoms which could delay the diagnosis of HF. Studies have shown that in UK primary care, HF failure treatment for COPD patients is delayed by almost twelve months compared to patient without COPD. Early diagnosis and management of HF for COPD patients in primary care could reduce risk of recurrent exacerbation and subsequent hospitalisation. HF screen is not currently emphasised in the primary care COPD annual reviews. NICE guidance for COPD diagnosis mentions the use of serum natriuretic peptides to aid differential diagnosis of HF.
Aim:
Reduce HF related complication including exacerbations and subsequent hospital admissions for COPD patients through early HF diagnosis and management programme.
Methods:
Emis search completed for COPD patients.
Patients were screened for HF symptoms (breathlessness, fluid retention, fatigue, lightheadness) on COPD annual review as per NICE guidance for HF screen.
NT-proBNP test was added to routine annual blood test for patients experiencing any of the HF symptoms.
Patients with elevated NT-ProBNP >400ng/L were referred for further assessment for suspected HF.
Results:
Early analysis (April-June 2023): Twenty patients screened out of 48 (41.6%), five patients (25%) had NT-pro BNP results over 400ng/L and were referred for further investigation for suspected HF and to optimise their management plan.
Conclusion:
Early results analysis correlates with published data regarding the prevalence of HF in COPD patients. COPD management could be optimised by early diagnosis and management of HF. Patients’ spontaneous feedback was positive regarding the new management approach.
Next steps:
Patients' feedback questionnaire and a 12-month longitudinal follow-up to investigate potential long-term benefits of early diagnosis.
Conflicts of interest: No conflict of interest was identified.
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