COPD Management in Primary Care: Underutilisation of Nursing Consultations
COPD Primary Care Nursing and Healthcare Utilisation Overview
COPD Primary Care Nursing and Healthcare Utilisation Overview
To describe the clinical profile, comorbidity burden, follow-up and healthcare utilisation in patients labelled as having Chronic Obstructive Pulmonary Disease (COPD) in Primary Care (PC) nursing consultations.
Design: Real-world data COPD, retrospective, observational study using routinely collected data in electronic health records (EHR).
This study adheres to the STROBE reporting guidelines for cross-sectional studies.
Patient Characteristics and Data Collection in COPD Management
All patients aged ≥ 15 years with a recorded diagnosis of COPD in their EHR, excluding institutionalised individuals and those deceased before study onset.
Final sample: 474 patients (105 women, 369 men; mean age 70 years) from a reference population of 28,000 individuals.
Main measurements
Data included socio-demographics, smoking/alcohol, mMRC dyspnea, inhaled therapy/adherence, spirometry, comorbidities, Adjusted Morbidity Groups (GMA), active COPD care plans and 12-month healthcare use.
Key Findings on COPD Nursing Consultations and Comorbidities
EHR showed a high rate of missing data in follow-up variables (inhaler adherence 28.5%; dyspnea 17%-20%).
Despite that, all participants were ‘labelled’ as COPD, most of them lacked spirometric confirmation. Active smoking was highly prevalent (52.3% women, 45.0% men). Hypertension, obesity and osteoarthritis were the most common comorbidities; anxiety, depression, osteoporosis and thyroid disorders were more frequent in women.
Higher GMA complexity correlated with more Primary Care visits, especially nursing consultations, particularly in patients with cardiovascular disease and diabetes (p < 0.001) for 12 months follow-up.
Conclusions on Improving COPD Care Through Nursing
EHR-labelled COPD patients with cardiometabolic comorbidity received more structured nursing follow-up and more annual visits than without. Improving EHR recording, integrating spirometry with the EHR, and prioritising high-complexity profiles could enhance monitoring, treatment optimisation and equity-nursing consultations are a key lever.
Authors
Marc Vila, Meritxell Mondejar, Sergio Cazorla-Calderón, Àngels Ballarin, Sandra Casas-Recasens, Rosa Faner, Alvar Agustí
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Fecha de publicación
2026 Feb 12
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