Understanding cardiopulmonary risk in COPD: A stakeholder engagement methods study (ID 487)
Department of Respiratory Medicine, Musgrove Park Hospital, Taunton and Somerset NHS Foundation Trust, UK
Funding: This abstract was sponsored by AstraZeneca. Medical writing support for the preparation of this abstract was provided by Lucid Group, London, UK, and funded by AstraZeneca.
Abstract
Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death in the UK.[1] In individuals with COPD, presence of cardiovascular disease increases mortality risk by up to 90%.[2] COPD exacerbations are associated with increased risk of major respiratory and cardiovascular events, making reduction of COPD-driven cardiopulmonary risk central to premature death prevention. Despite this, there exists no UK best-practice approach to COPD risk management.Methods: A multidisciplinary group of respiratory and cardiovascular specialists from primary and secondary care delivered stakeholder engagement methods including working groups, symposia and hot-topic sessions. These were leveraged to review evidence (randomised trials, observational studies, treatment guidance, quantitative and qualitative market research), generate concepts, and gather feedback on cardiopulmonary risk and clinical attitudes and behaviours surrounding COPD care and outcomes.
Results: Between May 2022 and June 2023, ~1,280 engagements with respiratory and cardiology specialists, nurses, pharmacists and GPs took place. Stakeholder activities revealed five key priorities: acknowledgement of disease burden and need to reduce premature mortality; exacerbation-driven cardiopulmonary risk; recognition of a COPD/cardiovascular mortality signal; policy updates to replicate risk prevention in cardiology; and practice optimisation. A scientific narrative, underpinned by these themes and published literature, was developed to address cardiopulmonary risk and outline optimised care opportunities. This work resulted in formation of a UK Cardiopulmonary Taskforce of multidisciplinary healthcare professionals, informing objectives for activities to drive COPD care transformation. It also shaped a response to the Department of Health and Social Care’s Major Conditions Strategy call for evidence.
Conclusion: Using stakeholder engagement methods and formation of a UK Cardiopulmonary Taskforce, a COPD cardiopulmonary risk narrative has been created to inform clinical, academic and policy approaches to improving care and outcomes for people with COPD.
References: 1. Office for National Statistics. Death registration statistics. 2022; 2. Miller J, et al. Respir Med. 2013;107(9):1376–84.
Conflicts of interest: Dinesh Shrikrishna has received speaker honoraria for attendance at advisory boards and presentations at meetings from AstraZeneca, Bayer, Bristol Myers Squibb, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Pfizer and Teva.
Matthew J. Pavitt is a member of the British Thoracic Society's Clinical Statement on Pulmonary Rehabilitation and COPD Advisory Group. He has also received speaker honoraria from AstraZeneca.
Alicia Piwko is a member of the Education Sub-Committee of PCRS.
Sivatharshini Ramalingam has nothing to declare.
John Steer has received speaker honoraria from AstraZeneca, Pfizer and GSK, grants from Cheisi and Menarini, and conference attendance support from AstraZeneca and GSK.
Carol Stonham has received unconditional speaker fees, honoraria, education delivery and consultancy via a limited company from AstraZeneca, Bedfont, Boehringer Ingelheim, Chiesi, GSK, Teva and Trudell. Carol Stonham is Chair of the PCRS Executive Committee.
Robert F. Storey has received institutional research grants from AstraZeneca, Cytosorbents and GlyCardial Diagnostics; and has received consultancy fees from AlfaSigma, Alnylam, Amgen, AstraZeneca, Bayer, Bristol Myers Squibb/Pfizer, Chiesi, CSL Behring, Cytosorbents, Daiichi-Sankyo, GlyCardial Diagnostics, Hengrui, Idorsia, Novartis, PhaseBio, Sanofi and Thromboserin.
Clare J. Taylor reports personal fees from Vifor and Novartis and non-financial support from Roche.
Yang Xu is an employee of AstraZeneca UK.
Chris P. Gale has completed consultancy work for AstraZeneca, Bayer, Bristol Myers Squibb, Boehringer Ingelheim, Chiesi, Daiichi Sanky, Menarini and Organon, and received speaker fees from AstraZeneca, Medisetter, Menarini, Raisio Group, Wondr Medical and Zydus. He is Deputy Editor for European Heart Journal Quality of Care and Clinical Outcomes, Oxford University Press, and received grants from British Heart Foundation, National Institute for Health Research, Horizon 2020, Abbott Diabetes and Bristol Myers Squibb. Fees for advisory board roles have been received from AI Nexus Inc., Amgen, Bayer, Bristol Myers, Squibb, Boehringer Ingelheim, Cardiomatics, Chiesi, Daiichi Sankyo, GPRI Research B.V., iRhythm and Menarini. Chris P. Gale is a member of the NICE Indicator Advisory Committee, Chair ESC Quality Indicator Committee, Chair Data Science Group, EuroHeart. He also has a patent in consideration with FIND-AF.
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