Please use this identifier to cite or link to this item: http://hdl.handle.net/10668/2298
Title: Guideline Adherence in Outpatient Clinics for Chronic Obstructive Pulmonary Disease: Results from a Clinical Audit.
Authors: López-Campos, Jose L
Abad Arranz, Maria
Calero-Acuña, Carmen
Romero-Valero, Fernando
Ayerbe-García, Ruth
Hidalgo-Molina, Antonio
Aguilar-Pérez-Grovas, Ricardo I
García-Gil, Francisco
Casas-Maldonado, Francisco
Caballero-Ballesteros, Laura
Sánchez-Palop, María
Pérez-Tejero, Dolores
Segado, Alejandro
Calvo-Bonachera, Jose
Hernández-Sierra, Bárbara
Doménech, Adolfo
Arroyo-Varela, Macarena
González-Vargas, Francisco
Cruz-Rueda, Juan J
metadata.dc.contributor.authoraffiliation: [López-Campos,JL; Abad Arranz,M; Calero-Acuña,C] Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, Spain. [López-Campos,JL; Calero-Acuña,C] CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, Spain. [Romero-Valero,F; Hidalgo-Molina,A] Hospital Puerta del Mar, Cádiz, Spain. [Ayerbe-García,R; Aguilar-Pérez-Grovas,RI] Hospital Juan Ramón Jiménez, Huelva, Spain. [García-Gil,F; Caballero-Ballesteros,L] Hospital Universitario Reina Sofía, Córdoba, Spain. [Casas-Maldonado,F; Sánchez-Palop,M] Hospital Universitario San Cecilio, Granada, Spain. [Pérez-Tejero,D; Segado,A] Hospital Infanta Margarita, Cabra, Córdoba, Spain. [Calvo-Bonachera,J; Hernández-Sierra,B] Hospital Torrecárdenas, Almería, Spain. [Doménech,A; Arroyo-Varela,M] Hospital Regional Universitario de Málaga, Málaga, Spain. [González-Vargas,F; Cruz-Rueda,JJ] Hospital Universitario Virgen de las Nieves, Granada, Spain.
Keywords: Instituciones de atención ambulatoria;Broncodilatadores;Auditoría clínica;Hospitales;Pacientes ambulatorios;Enfermedad pulmonar obstructiva crónica;Hábito de fumar;España;Espirometría;Vacunación;Alfa 1-antitripsina
metadata.dc.subject.mesh: Medical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::Ambulatory Care Facilities
Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Peripheral Nervous System Agents::Autonomic Agents::Bronchodilator Agents
Medical Subject Headings::Health Care::Health Services Administration::Quality of Health Care::Quality Assurance, Health Care::Clinical Audit
Medical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::Hospitals
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Named Groups::Persons::Patients::Outpatients
Medical Subject Headings::Diseases::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive
Medical Subject Headings::Diseases::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Statistics as Topic::Probability::Risk::Risk Factors
Medical Subject Headings::Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Habits::Smoking
Medical Subject Headings::Geographicals::Geographic Locations::Europe::Spain
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Diagnosis::Diagnostic Techniques and Procedures::Diagnostic Techniques, Respiratory System::Respiratory Function Tests::Spirometry
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Biological Therapy::Immunomodulation::Immunotherapy::Immunization::Immunotherapy, Active::Vaccination
Medical Subject Headings::Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Peptides::Proteinase Inhibitory Proteins, Secretory::Serpins::alpha 1-Antitrypsin
Issue Date: 17-Mar-2016
Publisher: Public Library of Science
Citation: López-Campos JL, Abad Arranz M, Calero-Acuña C, Romero-Valero F, Ayerbe-García R, Hidalgo-Molina A, et al. Guideline Adherence in Outpatient Clinics for Chronic Obstructive Pulmonary Disease: Results from a Clinical Audit. PLoS ONE. 2016; 11(3):e0151896
Abstract: OBJECTIVES Previous clinical audits of COPD have provided relevant information about medical intervention in exacerbation admissions. The present study aims to evaluate adherence to current guidelines in COPD through a clinical audit. METHODS This is a pilot clinical audit performed in hospital outpatient respiratory clinics in Andalusia, Spain (eight provinces with more than 8 million inhabitants), including 9 centers (20% of the public centers in the area) between 2013 and 2014. Cases with an established diagnosis of COPD based on risk factors, clinical symptoms, and a post-bronchodilator FEV1/FVC ratio of less than 0.70 were deemed eligible. The performance of the outpatient clinics was benchmarked against three guidance documents available at the time of the audit. The appropriateness of the performance was categorized as excellent (>80%), good (60-80%), adequate (40-59%), inadequate (20-39%), and highly inadequate (<20%). RESULTS During the audit, 621 clinical records were audited. Adherence to the different guidelines presented a considerable variability among the different participating hospitals, with an excellent or good adherence for symptom recording, MRC or CAT use, smoking status evaluation, spirometry, or bronchodilation therapy. The most outstanding areas for improvement were the use of the BODE index, the monitoring of treatments, the determination of alpha1-antitrypsin, the performance of exercise testing, and vaccination recommendations. CONCLUSIONS The present study reflects the situation of clinical care for COPD patients in specialized secondary care outpatient clinics. Adherence to clinical guidelines shows considerable variability in outpatient clinics managing COPD patients, and some aspects of the clinical care can clearly be improved.
Description: Journal Article
URI: http://hdl.handle.net/10668/2298
metadata.dc.relation.publisherversion: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0151896#abstract0
metadata.dc.identifier.doi: 10.1371/journal.pone.0151896
ISSN: 1932-6203 (Online)
Appears in Collections:01- Artículos - AGS Sur de Córdoba
01- Artículos - Complejo Hospitalario Torrecárdenas
01- Artículos - Complejo Hospitalario Universitario de Granada
01- Artículos - Hospital Juan Ramón Jiménez
01- Artículos - Hospital Puerta del Mar
01- Artículos - Hospital Regional de Málaga
01- Artículos - Hospital Reina Sofía
01- Artículos - Hospital Virgen del Rocío
01- Artículos - IBIS. Instituto de Biomedicina de Sevilla

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