Assessment of psychosocial problems in primary care COPD patients

The emphasis placed on assessing psychosocial needs in nurse-led practice based consultations for chronic obstructive pulmonary disease (COPD) has not been reported. We investigated the frequency with which nurses performed a range of tasks, and explored if the types of tasks performed were related to levels of training or the setting of clinical consultations. Participants were lead COPD nurses based at 500 randomly selected UK general practices. Respondents completed a questionnaire between February and June 2006. The frequency with which key task were performed - never, sometimes, often or always - was recorded. Follow-up consultations were conducted by 349 of the 368 nurses who responded (74% response rate). Of these, 51% (95% confidence interval (CI):45-56%) reported often or always assessing psychosocial needs, in comparison to 98% (97-99%) who reported often or always checking inhaler technique and 86% (82-89%) who often or always recorded spirometry values. Frequent assessment of psychosocial needs was associated with postregistration COPD education and consultations taking place in designated respiratory clinics. Nurses focus on objective tasks, possibly to the detriment of assessing psychosocial needs. To raise the profile of these aspects of care: updates of the COPD section of the GMS contract should encompass the assessment of patient's psychosocial status and potential impact of this on quality of life; and appropriate education should be provided.