scholarly journals Community Pharmacy—Based Medication Assessment Program for Asthma and Chronic Obstructive Pulmonary Disease

2012 ◽  
Vol 145 (2) ◽  
pp. 70-71 ◽  
Author(s):  
Marie-France Beauchesne ◽  
Delphine Bercier ◽  
Frédéric Julien-Baker ◽  
Lyne Lalonde ◽  
Robert Boileau ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Community Pharmacy ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Assessment Program

scholarly journals Community Pharmacy-Based Program for Patients with Asthma and Chronic Obstructive Pulmonary Disease

2012 ◽  
Vol 26 (6) ◽  
pp. 3437-3442 ◽  
Author(s):  
Valentina Petkova ◽  
Kalina Andreevska ◽  
Stanislav Gueurguiev ◽  
Daniela Grekova ◽  
Milen Dimitrov ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Community Pharmacy ◽  
Pulmonary Disease ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease

scholarly journals Quality Improvement Initiatives to Optimize the Management of Chronic Obstructive Pulmonary Disease in Patients With Lung Cancer

2017 ◽  
Vol 13 (11) ◽  
pp. e957-e965
Author(s):  
Geneviève C. Digby ◽  
Andrew Robinson
Keyword(s):  
Lung Cancer ◽  
Chronic Obstructive Pulmonary Disease ◽  
Quality Improvement ◽  
Pulmonary Disease ◽  
Airflow Obstruction ◽  
Diagnostic Assessment ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Assessment Program ◽  
Over Time

Purpose: Patients with lung cancer (LC) frequently have chronic obstructive pulmonary disease (COPD), the optimization of which improves outcomes. A 2014 Queen’s University Hospitals audit demonstrated that COPD was underdiagnosed and undertreated in outpatients with LC. We sought to improve the diagnosis and management of COPD in this population. Methods: We implemented change using a Define/Measure/Analyze/Improve/Control (DMAIC) improvement cycle. Data were obtained by chart review from the Cancer Care Ontario database and e-Patient System for patients with newly diagnosed LC, including patient characteristics, pulmonary function test (PFT) data, and bronchodilator therapies. Improvement cycle 1 included engaging stakeholders and prioritizing COPD management by respirologists in the Lung Diagnostic Assessment Program. Improvement cycle 2 included physician restructuring and developing a standard work protocol. Data were analyzed monthly and presented on statistical process control P-charts, which assessed differences over time. The χ2 and McNemar tests assessed for significance between independent and dependent groups, respectively. Results: A total of 477 patients were studied (165 patients at baseline, 166 patients in cycle 1, and 127 patients in cycle 2). There was no change in PFT completion over time, although respirology-managed patients were significantly more likely to undergo a PFT than patients who were not managed by respirology (56.7% v 96.1%; P < .00001). The proportion of respirology-managed patients with LC with airflow obstruction receiving inhaled bronchodilator significantly increased (baseline, 46.3%; cycle 1, 51.0%; and cycle 2, 74.3%). By cycle 2, patients with airflow obstruction were more likely to receive a long-acting bronchodilator if managed by respirology (74.3% v 44.8%; P = .0009). Conclusion: COPD is underdiagnosed and undertreated in outpatients with LC. A DMAIC quality improvement strategy emphasizing COPD treatment during LC evaluation in the Lung Diagnostic Assessment Program significantly improved COPD management.

scholarly journals Influence of Government-driven Quality Assessment Program on Patients with Chronic Obstructive Pulmonary Disease

2020 ◽  
Author(s):  
Hye Jung Park ◽  
Sung-Ryeol Kim ◽  
Sinae Kim ◽  
Hye Sun Lee ◽  
Bo Yeon Kim ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Insurance ◽  
Pulmonary Function ◽  
Quality Assessment ◽  
Pulmonary Disease ◽  
Pulmonary Function Test ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Assessment Program ◽  
Function Test

Abstract Background: The Korean Health Insurance Review and Assessment Service (HIRA) has launched the Chronic Obstructive Pulmonary Disease (COPD) Quality Assessment Program (CQAP) since 2014. We aimed to reveal the influence of this national program on clinical outcomes and the burden of COPD in Korea. Methods: The CQAP is conducted annually. We used healthcare claims data linked with the results of the program provided by HIRA between May 2014 and April 2017. Patients were considered to have COPD if they visited a hospital for COPD management during the assessment term. Those who visited a medical institution for COPD and were prescribed COPD medications at least twice were assessed by the CQAP (assessed subjects, AS; not-assessed subjects, NAS). CQAP evaluated the pulmonary function test conduction rate, regular visitation rate, and prescription rates of COPD medications.Results: Among the 560,000 patients with COPD, about 140,000 were assessed by the CQAP annually. In both groups, the pulmonary function test conduction rate and inhaled bronchodilator prescription rate improved since 2014. Compared to the NAS group, the risk of admission and all-cause mortality rate in the AS group were significantly reduced by 21.2% and 40.7%, respectively. In patients who were assessed for 3 consecutive years, all of the above variables were high at baseline and did not improve much from the CQAP. In matching analysis, we observed this improvement to be limited in the COPD quality assessment year. Conclusions: The CQAP by the health insurance bureau has improved the management protocol and prognosis of COPD.

scholarly journals Influence of government-driven quality assessment program on patients with chronic obstructive pulmonary disease

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Hye Jung Park ◽  
Sung-Ryeol Kim ◽  
Sinae Kim ◽  
Hye Sun Lee ◽  
Bo Yeon Kim ◽  
...  
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Health Insurance ◽  
Pulmonary Function ◽  
Quality Assessment ◽  
Pulmonary Disease ◽  
Pulmonary Function Test ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Assessment Program ◽  
Function Test

Abstract Background The Korean Health Insurance Review and Assessment Service (HIRA) has launched the Chronic Obstructive Pulmonary Disease (COPD) Quality Assessment Program (CQAP) since 2014. We aimed to reveal the influence of this national program on clinical outcomes and the burden of COPD in Korea. Methods The CQAP is conducted annually. We used healthcare claims data linked with the results of the program provided by HIRA between May 2014 and April 2017. Patients were considered to have COPD if they visited a hospital for COPD management during the assessment term. Those who visited a medical institution for COPD and were prescribed COPD medications at least twice were assessed by the CQAP (assessed subjects, AS; not-assessed subjects, NAS). CQAP evaluated the pulmonary function test conduction rate, regular visitation rate, and prescription rates of COPD medications. Results Among the 560,000 patients with COPD, about 140,000 were assessed by the CQAP annually. In both groups, the pulmonary function test conduction rate and inhaled bronchodilator prescription rate improved since 2014. Compared to the NAS group, the risk of admission and all-cause mortality rate in the AS group were significantly reduced by 21.2% and 40.7%, respectively. In patients who were assessed for 3 consecutive years, all of the above variables were high at baseline and were not improved much from implementation of CQAP. In matching analysis, we observed this improvement to be limited in the COPD quality assessment year. Conclusions The CQAP by the health insurance bureau has improved the management protocol and prognosis of COPD.

Oral and Oropharyngeal Sensory Function in Adults With Chronic Obstructive Pulmonary Disease

2020 ◽  
Vol 29 (2) ◽  
pp. 864-872
Author(s):  
Fernanda Borowsky da Rosa ◽  
Adriane Schmidt Pasqualoto ◽  
Catriona M. Steele ◽  
Renata Mancopes
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
Oral Cavity ◽  
Pulmonary Disease ◽  
Thermal Sensation ◽  
Sensory Function ◽  
Control Group ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Age Related ◽  
Copd Patients

Introduction The oral cavity and pharynx have a rich sensory system composed of specialized receptors. The integrity of oropharyngeal sensation is thought to be fundamental for safe and efficient swallowing. Chronic obstructive pulmonary disease (COPD) patients are at risk for oropharyngeal sensory impairment due to frequent use of inhaled medications and comorbidities including gastroesophageal reflux disease. Objective This study aimed to describe and compare oral and oropharyngeal sensory function measured using noninstrumental clinical methods in adults with COPD and healthy controls. Method Participants included 27 adults (18 men, nine women) with a diagnosis of COPD and a mean age of 66.56 years ( SD = 8.68). The control group comprised 11 healthy adults (five men, six women) with a mean age of 60.09 years ( SD = 11.57). Spirometry measures confirmed reduced functional expiratory volumes (% predicted) in the COPD patients compared to the control participants. All participants completed a case history interview and underwent clinical evaluation of oral and oropharyngeal sensation by a speech-language pathologist. The sensory evaluation explored the detection of tactile and temperature stimuli delivered by cotton swab to six locations in the oral cavity and two in the oropharynx as well as identification of the taste of stimuli administered in 5-ml boluses to the mouth. Analyses explored the frequencies of accurate responses regarding stimulus location, temperature and taste between groups, and between age groups (“≤ 65 years” and “> 65 years”) within the COPD cohort. Results We found significantly higher frequencies of reported use of inhaled medications ( p < .001) and xerostomia ( p = .003) in the COPD cohort. Oral cavity thermal sensation ( p = .009) was reduced in the COPD participants, and a significant age-related decline in gustatory sensation was found in the COPD group ( p = .018). Conclusion This study found that most of the measures of oral and oropharyngeal sensation remained intact in the COPD group. Oral thermal sensation was impaired in individuals with COPD, and reduced gustatory sensation was observed in the older COPD participants. Possible links between these results and the use of inhaled medication by individuals with COPD are discussed.

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