Cardiff University | Prifysgol Caerdydd ORCA
Online Research @ Cardiff 
WelshClear Cookie - decide language by browser settings

Associations with post-consultation health-status in primary care managed acute exacerbation of COPD

Gillespie, David ORCID:, Francis, Nick, Ahmed, Haroon ORCID:, Hood, Kerenza ORCID:, Llor, Carl, White, Patrick, Thomas-Jones, Emma ORCID:, Stanton, Helen, Sewell, Bernadette, Phillips, Rhiannon, Naik, Gurudutt ORCID:, Melbye, Hasse, Lowe, Rachel, Kirby, Nigel, Cochrane, Ann, Bates, Janine, Alam, Mohammed Fasihul and Butler, Christopher 2022. Associations with post-consultation health-status in primary care managed acute exacerbation of COPD. International Journal of Chronic Obstructive Pulmonary Disease 2022 (17) , pp. 383-394. 10.2147/COPD.S340710

[thumbnail of Factors associated with post-cons COPD health status in AECOPD - Manuscript R1 081221 CLEAN.pdf]
PDF - Accepted Post-Print Version
Available under License Creative Commons Attribution Non-commercial.

Download (312kB) | Preview


Background: It has been demonstrated that antibiotic prescribing for Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) can be safely reduced in primary care when general practitioners have access to C-reactive protein (CRP) rapid testing. Aim: To investigate the factors associated with post-consultation COPD health status in patients presenting with AECOPD in this setting. Design and Setting: A cohort study of patients enrolled in a randomised controlled trial. Patients aged 40+ years with a clinical diagnosis of COPD who presented in primary care across England and Wales with an AECOPD were included. Methods: Participants were contacted for follow-up at one- and two-weeks by phone and attended the practice four weeks after the index consultation. The outcome of interest was the Clinical COPD Questionnaire (CCQ) score. Multivariable multilevel linear regression models fitted to examine the factors associated with COPD health status in the four-weeks following consultation for an AECOPD. Results: A total of 649 patients were included, with 1947 CCQ total scores analysed. Post-consultation CCQ total scores were significantly higher (worse) in participants with diabetes (adjusted mean difference [AMD]=0.26; 95% confidence interval (CI) 0.08– 0.45), obese patients compared to those with normal body mass index (AMD = 0.25, 95% CI 0.07– 0.43), and those who were prescribed oral antibiotics in the prior 12 months (AMD = 0.26; 95% CI 0.11– 0.41), but only the two latter associations remained after adjusting for other sociodemographic variables. Conclusion: COPD health status was worse in the four weeks following primary care consultation for AECOPD in patients with obesity and those prescribed oral antibiotics in the preceding year.

Item Type: Article
Date Type: Published Online
Status: Published
Schools: Medicine
Centre for Trials Research (CNTRR)
Publisher: Dove Press
ISSN: 1178-2005
Date of First Compliant Deposit: 10 March 2022
Date of Acceptance: 20 December 2021
Last Modified: 10 Nov 2023 16:45

Actions (repository staff only)

Edit Item Edit Item


Downloads per month over past year

View more statistics