Measuring the Impact of the CONQUEST COPD Quality Improvement Programme in UK Primary Care (ID 709)
Observational and Pragmatic Research Institute, United Kingdom
Abstract
Introduction
Previous studies have identified patients with diagnosed and potentially undiagnosed chronic obstructive pulmonary disease (COPD) who are ‘modifiable high-risk’ (MHR) i.e. have previous exacerbations, are more susceptible to poor health outcomes, and have scope for management optimisation (1). The CONQUEST quality improvement programme (QIP) details quality standards for the identification, assessment, treatment, and follow-up of patients with MHR COPD (2). The programme has been implemented by Optimum Patient Care in 84 UK primary care practices between 2022 and 2024.
Aims
CONQUEST-ADVANCE aims to demonstrate improvements in activities aligned with the CONQUEST quality standards (quality indicators) during the implementation of the CONQUEST QIP in the UK against controls that did not receive the QIP.
Methods
CONQUEST-ADVANCE is a retrospective cohort study. Data from the CONQUEST registry and the Optimum Patient Care Research Database compare quality indicators between patients at practices exposed to the CONQUEST QIP (exposed practices) and matched non-participating practices (control practices). The study contrasts changes in these quality indicators over 12-month and 6-month periods before (Pre-CONQUEST) and after CONQUEST implementation across three patient cohorts: (i) potential undiagnosed MHR COPD, (ii) newly diagnosed MHR COPD, and (iii) already diagnosed MHR COPD. Cohorts and outcomes are defined in Table 1. A combination of analytical strategies will be used to adjust for confounders at the practice and patient level.
Results
Available preliminary outcome data will be presented at the PCRS conference as frequencies and risk ratios (Table 2) that quantify the achievement of quality indicators by the CONQUEST QIP in the UK.
References
1. Halpin DMG, Dickens AP, Skinner D, Murray R, Singh M, Hickman K, et al. Identification of key opportunities for optimising the management of high-risk COPD patients in the UK using the CONQUEST quality standards: an observational longitudinal study. Lancet Reg Health - Eur. 2023 Jun 1;29:100619.
2. Alves L, Pullen R, Hurst JR, Miravitlles M, Carter V, Chen R, et al. CONQUEST: A Quality Improvement Program for Defining and Optimizing Standards of Care for Modifiable High-Risk COPD Patients. Patient Relat Outcome Meas. 2022 Feb 23;13:53–68.
3. Chronic obstructive pulmonary disease NICE; 2025 May. cks.nice.org.uk/topics/chronic-obstructive-pulmonary-disease/
Funding: This study was conducted by the Observational and Pragmatic Research Institute (OPRI) Pte Ltd and was partially funded by Optimum Patient Care Global and AstraZeneca Ltd. No funding was received by the Observational & Pragmatic Research Institute Pte Ltd (OPRI) for its contribution.
Conflicts of interest: Elango Vijaykumar is an Executive Partner at Modality Partnership and National Research Lead for Modality. Modality practices have participated in NIHR portfolio research and quality improvement projects, including respiratory disease programmes. EV has not received personal payments from AstraZeneca or Optimum Patient Care but has overseen research delivery within primary care settings.
Daryl Freeman reports no conflict of interest.
Daiana Stolz reports no conflict of interest.
Luís Alves has served as an advisor or consultant for AstraZeneca, GlaxoSmithKline and Merck Sharp & Dohme; served as a speaker or a member of a speakers bureau for AstraZeneca, GlaxoSmithKline, BIAL, Viatris and Novartis Pharmaceuticals Corporation.
Mohit Bhutani received grants paid to his institution by CIHR, AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Sanofi and Mereo. MB received speaker and consulting fees from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Sanofi, Valeo and Covis.
Rongchang Chen has received grant support from AstraZeneca, Boehringer Ingelheim, and GlaxoSmithKline; and reimbursement for advisory work and educational activities from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Novartis.
Chris P Gale has received grants for research from British Heart Foundation, National Institute for Health Research, Horizon 2020, Abbott Diabetes, Bristol Myers Squibb and European Society of Cardiology; consulting fees from AstraZeneca, Bayer, Bristol Myers Squibb, Boehrinher-Ingleheim, Boston Scientific, Chiesi, Daiichi Sankyo, Menarini and Organon; honoraria for speaking at meetings and educational events from AstraZeneca, Menarini, Novartis, Raisio Group, Wondr Medical and Zydus; support for attending meetings from Bayer and Bristol Myers Squibb; and has acted as an advisory board member for Amgen, AstraZeneca, Bayer, Bristol Myers Squibb, Boehrinher-Ingleheim, Chiesi, Daiichi Sankyo, Menarini, Novartis and iRhythm.
David MG Halpin has received sponsorship to attend international meetings, and honoraria for lecturing, attending advisory boards and preparing educational materials from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis and Pfizer.
Katherine Hickman reports no conflict of interest.
John R Hurst has grant support from AstraZeneca and has received personal payment and payment to his institution for educational and advisory work from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline and Sanofi.
Marc Miravitlles reports speaker fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Cipla, Menarini, Rovi, Bial, Sandoz, Zambon, CSL Behring, Grifols and Novartis, consulting fees from AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Bial, Gebro Pharma, Kamada, CSL Behring, Laboratorios Esteve, Ferrer, Mereo Biopharma, Verona Pharma, TEVA, Spin Therapeutics, Palobiofarma SL, pH Pharma, Novartis, Sanofi and Grifols and research grants from Grifols.
Tamsin Morris, Hana Müllerová, Jonatan Natman and Della Varghese are employees of AstraZeneca.
Jennifer Quint has been supported by institutional research grants from the Medical Research Council, NIHR, Health Data Research, GlaxoSmithKline, Boehringer Ingelheim, AstraZeneca, Insmed, and Sanofi and received personal fees for advisory board participation, consultancy, or speaking fees from GlaxoSmithKline, Boehringer Ingelheim, Sanofi, Chiesi, and AstraZeneca.
Dave Singh has received personal fees from Aerogen, AstraZeneca, Boehringer Ingelheim, Chiesi, Cipla, CSL Behring, EpiEndo, Genentech, GlaxoSmithKline, Glenmark, Gossamer Bio, Kinaset Therapeutics, Menarini, Novartis, Orion, Pulmatrix, Sanofi, Teva, Theravance Biopharma, and Verona Pharma.
Mukesh Singh reports previously received fees from AstraZeneca, Boehringer Ingelheim, Cheisi, GlaxoSmithKline, Napp/Mundipharma, Pfizer, and Teva.
is an employee of AstraZeneca.
Tonya Winders has received personal fees from AstraZeneca, GlaxoSmithKline, Novartis, Genentech, and Sanofi/Regeneron alliance. Allergy & Asthma Network & Global Allergy & Airways Patient Platform has received funds for unbranded disease awareness and education from AstraZeneca, Boehringer Ingelheim, GlaxoSmithKline, Novartis, Genentech, Viatris, and Sanofi/Regeneron.
James Gatenby, Alexander Evans, Andrew P Dickens, Victoria Carter, William Henley, Neva Eleangovan and Rachel Pullen are employees of Observational and Pragmatic Research International Ltd.
Amy Couper is contracted by the Observational and Pragmatic Research Institute (OPRI) Pte Ltd and Optimum Patient Care Global.
David B. Price has advisory board membership with AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis, Viatris, Teva Pharmaceuticals; consultancy agreements with AstraZeneca, Boehringer Ingelheim, Chiesi, GlaxoSmithKline, Novartis, Viatris, Teva Pharmaceuticals; grants and unrestricted funding for investigator-initiated studies (conducted through Observational and Pragmatic Research Institute Pte Ltd) from AstraZeneca, Chiesi, Viatris, Novartis, Regeneron Pharmaceuticals, Sanofi Genzyme, and UK National Health Service; payment for lectures/speaking engagements from AstraZeneca, Boehringer Ingelheim, Chiesi, Cipla, Inside Practice, GlaxoSmithKline, Medscape, Viatris, Novartis, Regeneron Pharmaceuticals and Sanofi Genzyme, Teva Pharmaceuticals; payment for travel/accommodation/meeting expenses from AstraZeneca, Boehringer Ingelheim, Novartis, Medscape, Teva Pharmaceuticals.; owns 74% of the social enterprise Optimum Patient Care Ltd (Australia and UK) and 92.61% of Observational and Pragmatic Research Institute Pte Ltd (Singapore); is peer reviewer for grant committees of the UK Efficacy and Mechanism Evaluation Programme, and Health Technology Assessment; and he was an expert witness for GlaxoSmithKline.