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Which chronic obstructive pulmonary disease care recommendations have low implementation and why? A pilot study
Kylie Johnston1, Karen Grimmer-Somers, Mary Young
1International Centre for Allied Health Evidence, Division of Health Sciences, University of South Australia, Adelaide, Australia. kylie.johnston@unisa.edu.au
BMC Research Notes
|November 27, 2012
Summary
Pulmonary rehabilitation referrals are underutilized in hospitalized COPD patients due to low awareness and access barriers. Further research is needed to address this evidence-practice gap for better COPD management.
Area of Science:
- Pulmonary Medicine
- Health Services Research
- Clinical Implementation Science
Background:
- Clinical guidelines recommend evidence-based care for Chronic Obstructive Pulmonary Disease (COPD).
- Implementation gaps exist for high-evidence COPD recommendations.
- Barriers and facilitators to guideline uptake are not well understood.
Purpose of the Study:
- To explore the implementation of key high-evidence COPD guideline recommendations in hospitalized patients.
- To identify barriers and facilitators to guideline adherence.
- To inform a larger observational study on COPD care.
Main Methods:
- Pilot study involving consecutive COPD patients admitted to a tertiary hospital.
- Data collection included patient demographics, disease characteristics, and medical records.
- Information on guideline implementation (smoking cessation, pulmonary rehabilitation, vaccination, medications, oxygen) was gathered via records and patient/doctor interviews.
Main Results:
- Fifteen patients and nine doctors participated.
- Pulmonary rehabilitation referral was underutilized (5/15 patients).
- Low awareness of pulmonary rehabilitation was a key barrier for patients and doctors; access and perceived benefits were also patient barriers.
Conclusions:
- Justification for a larger observational study on COPD care.
- Hypothesis: Pulmonary rehabilitation referral is low in suitable COPD patients.
- Further investigation is needed into the evidence-practice gap for pulmonary rehabilitation.
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