Improvement in the management of chronic obstructive pulmonary disease following a clinical educational program: Results from a prospective cohort study in the Sicilian general practice setting

Rosarita Ferrara, Valentina Ientile, Carlo Piccinni, Alessandro Pasqua, Serena Pecchioli, Andrea Fontana, Umberto Alecci, Riccardo Scoglio, Francesco Magliozzo, Sebastiano Emanuele Torrisi, Carlo Vancheri, Patrizio Vitulo, Giovanna Fantaci, Carmen Ferrajolo, Mario Cazzola, Claudio Cricelli, Achille Patrizio Caputi, Gianluca Trifirò

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disorder of the lungs associated with progressive disability. Although general practitioners (GPs) should play an important role in the COPD management, critical issues have been documented in the primary care setting. The aim of this study was to evaluate the effectiveness of an educational program for the improvement of the COPD management in a Sicilian general practice setting. The effectiveness of the program, was evaluated by comparing 15 quality-of-care indicators developed from data extracted by 33 GPs, at baseline vs. 12 and 24 months, and compared with data from a national primary care database (HSD). Moreover, data on COPD-related and all-cause hospitalizations over time of COPD patients, was measured. Overall, 1,465 patients (3.2%) had a registered diagnosis of COPD at baseline vs. 1,395 (3.0%) and 1,388 (3.0%) over time (vs. 3.0% in HSD). COPD patients with one spirometry registered increased from 59.7% at baseline to 73.0% after 2 years (vs. 64.8% in HSD). Instead, some quality of care indicators where not modified such as proportion of COPD patients treated with ICS in monotherapy that was almost stable during the study period: 9.6% (baseline) vs. 9.9% (after 2 years), vs. 7.7% in HSD. COPD-related and all-cause hospitalizations of patients affected by COPD decreased during the two observation years (from 6.9% vs. 4.0%; from 23.0% vs. 18.9%, respectively). Our study showed that educational program involving specialists, clinical pharmacologists and GPs based on training events and clinical audit may contribute to partly improve both diagnostic and therapeutic management of COPD in primary care setting, despite this effect may vary across GPs and indicators of COPD quality of care.

Original languageEnglish
Article number28
Journalnpj Primary Care Respiratory Medicine
Volume28
Issue number1
DOIs
Publication statusPublished - Dec 1 2018

Fingerprint

General Practice
Chronic Obstructive Pulmonary Disease
Cohort Studies
Prospective Studies
General Practitioners
Quality of Health Care
Primary Health Care
Program Evaluation
Disease Management
Hospitalization
Clinical Audit
Spirometry
Observation
Databases
Lung

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Public Health, Environmental and Occupational Health

Cite this

Improvement in the management of chronic obstructive pulmonary disease following a clinical educational program : Results from a prospective cohort study in the Sicilian general practice setting. / Ferrara, Rosarita; Ientile, Valentina; Piccinni, Carlo; Pasqua, Alessandro; Pecchioli, Serena; Fontana, Andrea; Alecci, Umberto; Scoglio, Riccardo; Magliozzo, Francesco; Torrisi, Sebastiano Emanuele; Vancheri, Carlo; Vitulo, Patrizio; Fantaci, Giovanna; Ferrajolo, Carmen; Cazzola, Mario; Cricelli, Claudio; Caputi, Achille Patrizio; Trifirò, Gianluca.

In: npj Primary Care Respiratory Medicine, Vol. 28, No. 1, 28, 01.12.2018.

Research output: Contribution to journalArticle

Ferrara, R, Ientile, V, Piccinni, C, Pasqua, A, Pecchioli, S, Fontana, A, Alecci, U, Scoglio, R, Magliozzo, F, Torrisi, SE, Vancheri, C, Vitulo, P, Fantaci, G, Ferrajolo, C, Cazzola, M, Cricelli, C, Caputi, AP & Trifirò, G 2018, 'Improvement in the management of chronic obstructive pulmonary disease following a clinical educational program: Results from a prospective cohort study in the Sicilian general practice setting', npj Primary Care Respiratory Medicine, vol. 28, no. 1, 28. https://doi.org/10.1038/s41533-018-0077-7
Ferrara, Rosarita ; Ientile, Valentina ; Piccinni, Carlo ; Pasqua, Alessandro ; Pecchioli, Serena ; Fontana, Andrea ; Alecci, Umberto ; Scoglio, Riccardo ; Magliozzo, Francesco ; Torrisi, Sebastiano Emanuele ; Vancheri, Carlo ; Vitulo, Patrizio ; Fantaci, Giovanna ; Ferrajolo, Carmen ; Cazzola, Mario ; Cricelli, Claudio ; Caputi, Achille Patrizio ; Trifirò, Gianluca. / Improvement in the management of chronic obstructive pulmonary disease following a clinical educational program : Results from a prospective cohort study in the Sicilian general practice setting. In: npj Primary Care Respiratory Medicine. 2018 ; Vol. 28, No. 1.
@article{cbfefb34ffae4dc6b6007156a0c2cf0d,
title = "Improvement in the management of chronic obstructive pulmonary disease following a clinical educational program: Results from a prospective cohort study in the Sicilian general practice setting",
abstract = "Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disorder of the lungs associated with progressive disability. Although general practitioners (GPs) should play an important role in the COPD management, critical issues have been documented in the primary care setting. The aim of this study was to evaluate the effectiveness of an educational program for the improvement of the COPD management in a Sicilian general practice setting. The effectiveness of the program, was evaluated by comparing 15 quality-of-care indicators developed from data extracted by 33 GPs, at baseline vs. 12 and 24 months, and compared with data from a national primary care database (HSD). Moreover, data on COPD-related and all-cause hospitalizations over time of COPD patients, was measured. Overall, 1,465 patients (3.2{\%}) had a registered diagnosis of COPD at baseline vs. 1,395 (3.0{\%}) and 1,388 (3.0{\%}) over time (vs. 3.0{\%} in HSD). COPD patients with one spirometry registered increased from 59.7{\%} at baseline to 73.0{\%} after 2 years (vs. 64.8{\%} in HSD). Instead, some quality of care indicators where not modified such as proportion of COPD patients treated with ICS in monotherapy that was almost stable during the study period: 9.6{\%} (baseline) vs. 9.9{\%} (after 2 years), vs. 7.7{\%} in HSD. COPD-related and all-cause hospitalizations of patients affected by COPD decreased during the two observation years (from 6.9{\%} vs. 4.0{\%}; from 23.0{\%} vs. 18.9{\%}, respectively). Our study showed that educational program involving specialists, clinical pharmacologists and GPs based on training events and clinical audit may contribute to partly improve both diagnostic and therapeutic management of COPD in primary care setting, despite this effect may vary across GPs and indicators of COPD quality of care.",
author = "Rosarita Ferrara and Valentina Ientile and Carlo Piccinni and Alessandro Pasqua and Serena Pecchioli and Andrea Fontana and Umberto Alecci and Riccardo Scoglio and Francesco Magliozzo and Torrisi, {Sebastiano Emanuele} and Carlo Vancheri and Patrizio Vitulo and Giovanna Fantaci and Carmen Ferrajolo and Mario Cazzola and Claudio Cricelli and Caputi, {Achille Patrizio} and Gianluca Trifir{\`o}",
year = "2018",
month = "12",
day = "1",
doi = "10.1038/s41533-018-0077-7",
language = "English",
volume = "28",
journal = "npj Primary Care Respiratory Medicine",
issn = "2055-1010",
publisher = "Nature Publishing Group",
number = "1",

}

TY - JOUR

T1 - Improvement in the management of chronic obstructive pulmonary disease following a clinical educational program

T2 - Results from a prospective cohort study in the Sicilian general practice setting

AU - Ferrara, Rosarita

AU - Ientile, Valentina

AU - Piccinni, Carlo

AU - Pasqua, Alessandro

AU - Pecchioli, Serena

AU - Fontana, Andrea

AU - Alecci, Umberto

AU - Scoglio, Riccardo

AU - Magliozzo, Francesco

AU - Torrisi, Sebastiano Emanuele

AU - Vancheri, Carlo

AU - Vitulo, Patrizio

AU - Fantaci, Giovanna

AU - Ferrajolo, Carmen

AU - Cazzola, Mario

AU - Cricelli, Claudio

AU - Caputi, Achille Patrizio

AU - Trifirò, Gianluca

PY - 2018/12/1

Y1 - 2018/12/1

N2 - Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disorder of the lungs associated with progressive disability. Although general practitioners (GPs) should play an important role in the COPD management, critical issues have been documented in the primary care setting. The aim of this study was to evaluate the effectiveness of an educational program for the improvement of the COPD management in a Sicilian general practice setting. The effectiveness of the program, was evaluated by comparing 15 quality-of-care indicators developed from data extracted by 33 GPs, at baseline vs. 12 and 24 months, and compared with data from a national primary care database (HSD). Moreover, data on COPD-related and all-cause hospitalizations over time of COPD patients, was measured. Overall, 1,465 patients (3.2%) had a registered diagnosis of COPD at baseline vs. 1,395 (3.0%) and 1,388 (3.0%) over time (vs. 3.0% in HSD). COPD patients with one spirometry registered increased from 59.7% at baseline to 73.0% after 2 years (vs. 64.8% in HSD). Instead, some quality of care indicators where not modified such as proportion of COPD patients treated with ICS in monotherapy that was almost stable during the study period: 9.6% (baseline) vs. 9.9% (after 2 years), vs. 7.7% in HSD. COPD-related and all-cause hospitalizations of patients affected by COPD decreased during the two observation years (from 6.9% vs. 4.0%; from 23.0% vs. 18.9%, respectively). Our study showed that educational program involving specialists, clinical pharmacologists and GPs based on training events and clinical audit may contribute to partly improve both diagnostic and therapeutic management of COPD in primary care setting, despite this effect may vary across GPs and indicators of COPD quality of care.

AB - Chronic obstructive pulmonary disease (COPD) is a chronic inflammatory disorder of the lungs associated with progressive disability. Although general practitioners (GPs) should play an important role in the COPD management, critical issues have been documented in the primary care setting. The aim of this study was to evaluate the effectiveness of an educational program for the improvement of the COPD management in a Sicilian general practice setting. The effectiveness of the program, was evaluated by comparing 15 quality-of-care indicators developed from data extracted by 33 GPs, at baseline vs. 12 and 24 months, and compared with data from a national primary care database (HSD). Moreover, data on COPD-related and all-cause hospitalizations over time of COPD patients, was measured. Overall, 1,465 patients (3.2%) had a registered diagnosis of COPD at baseline vs. 1,395 (3.0%) and 1,388 (3.0%) over time (vs. 3.0% in HSD). COPD patients with one spirometry registered increased from 59.7% at baseline to 73.0% after 2 years (vs. 64.8% in HSD). Instead, some quality of care indicators where not modified such as proportion of COPD patients treated with ICS in monotherapy that was almost stable during the study period: 9.6% (baseline) vs. 9.9% (after 2 years), vs. 7.7% in HSD. COPD-related and all-cause hospitalizations of patients affected by COPD decreased during the two observation years (from 6.9% vs. 4.0%; from 23.0% vs. 18.9%, respectively). Our study showed that educational program involving specialists, clinical pharmacologists and GPs based on training events and clinical audit may contribute to partly improve both diagnostic and therapeutic management of COPD in primary care setting, despite this effect may vary across GPs and indicators of COPD quality of care.

UR - http://www.scopus.com/inward/record.url?scp=85044364399&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85044364399&partnerID=8YFLogxK

U2 - 10.1038/s41533-018-0077-7

DO - 10.1038/s41533-018-0077-7

M3 - Article

AN - SCOPUS:85044364399

VL - 28

JO - npj Primary Care Respiratory Medicine

JF - npj Primary Care Respiratory Medicine

SN - 2055-1010

IS - 1

M1 - 28

ER -