RT Journal Article
T1 Quantification of inaccurate diagnosis of COPD in primary care medicine: an analysis of the COACH clinical audit.
A1 Abad-Arranz, María
A1 Moran-Rodríguez, Ana
A1 Mascarós Balaguer, Enrique
A1 Quintana Velasco, Carmen
A1 Abad Polo, Laura
A1 Núñez Palomo, Sara
A1 Gonzálvez Rey, Jaime
A1 Fernández Vargas, Ana María
A1 Hidalgo Requena, Antonio
A1 Helguera Quevedo, Jose Manuel
A1 García Pardo, Marina
A1 Lopez-Campos, Jose Luis
K1 COPD
K1 clinical audit
K1 inaccurate diagnosis
K1 primary care medicine
AB Background: Inaccurate diagnosis in COPD is a current problem with relevant consequences in terms of inefficient health care, which has not been thoroughly studied in primary care medicine. The aim of the present study was to evaluate the degree of inaccurate diagnosis in Primary Care in Spain and study the determinants associated with it. Methods: The Community Assessment of COPD Health Care (COACH) study is a national, observational, randomized, non-interventional, national clinical audit aimed at evaluating clinical practice for patients with COPD in primary care medicine in Spain. For the present analysis, a correct diagnosis was evaluated based on previous exposure and airway obstruction with and without the presence of symptoms. The association of patient-level and center-level variables with inaccurate diagnosis was studied using multivariate multilevel binomial logistic regression models. Results: During the study 4,307 cases from 63 centers were audited. The rate of inaccurate diagnosis was 82.4% (inter-regional range from 76.8% to 90.2%). Patient-related interventions associated with inaccurate diagnosis were related to active smoking, lung function evaluation, and specific therapeutic interventions. Center-level variables related to the availability of certain complementary tests and different aspects of the resources available were also associated with an inaccurate diagnosis. Conclusions: The prevalence data for the inaccurate diagnosis of COPD in primary care medicine in Spain establishes a point of reference in the clinical management of COPD. The descriptors of the variables associated with this inaccurate diagnosis can be used to identify cases and centers in which inaccurate diagnosis is occurring considerably, thus allowing for improvement.
YR 2019
FD 2019-06-06
LK http://hdl.handle.net/10668/14176
UL http://hdl.handle.net/10668/14176
LA en
DS RISalud
RD Apr 17, 2025