Virtual Respiratory Clinics for Primary Care (ID 489)
Leeds Community Healthcare
Funding: West Yorkshire ICB - Inequalities funding
Abstract
Details of the issueVirtual Respiratory Clinics (VRCs) offer an innovative way of bringing together respiratory specialists and primary care clinicians to improve the care of people with COPD.
Data suggests approximately 25% of those diagnosed with COPD have an incorrect diagnosis – currently around 15,000 on COPD register in Leeds
Disease modifying medications improve morbidity and mortality.
COPD patients seem to have suffered significantly in the COVID 19 Pandemic due to Spirometry ceasing in Primary Care following anxiety around AGP and risks of transmission.
In summer 2021 a VRC pilot was set up within a GP practice in Leeds to evaluate whether this model would be as successful as other VRC’s around the country. The pilot was to review prescribing of inhaled corticosteroids in patients with COPD.
The aim was to review and risk stratify all COPD patients, to assess severity of COPD and only continue inhaled corticosteroids (ICS) where clinically appropriate, in line with the evidence base.
What we did
High risk patients (e.g more than 6 prednisolone courses in 12 months) were identified through searches on SystmOne. A template was developed to allow thorough holistic review of the patient, from confirming diagnosis to ensuring their management is optimised.
Development of a questionnaire template on SystmOne to capture diagnosis and both pharmacological and non-pharmacological recommendations.
Outcomes
170 patients reviewed:
80% correctly coded COPD
Out of these:
40% recommended pharmacological treatment change
More than 80% recommended non-pharmacological changes
13% did not have COPD
All GP practice staff involved felt supported with greater knowledge and confidence to review patients with COPD.
Importance of clinician with training in interpretation of spirometry to diagnose.
High percentage of patients do not use inhalers correctly – highlighted importance of clinicians exploring barriers to using inhalers with patients.
Conflicts of interest: None
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