Clinical control in COPD and therapeutic implications: The EPOCONSUL audit

Area of Science:

• Pulmonology
• Clinical Practice Research
• Health Services Research

Background:

• Chronic obstructive pulmonary disease (COPD) management requires ongoing assessment and treatment adjustment.
• Real-world clinical practice may present challenges in achieving optimal COPD control.
• Understanding factors influencing treatment decisions is crucial for improving patient outcomes.

Purpose of the Study:

• To evaluate clinical control in COPD patients.
• To assess treatment decisions and identify factors associated with clinical inertia during follow-up.
• To analyze real-life clinical practice in respiratory clinics.

Main Methods:

• A cross-sectional audit (EPOCONSUL 2021) of COPD outpatient care in Spain.
• Inclusion of 4225 patients from 45 hospitals.
• Multivariable logistic regression to analyze relationships between clinical control and therapeutic inertia.

Main Results:

• 49.1% of audited COPD patients were uncontrolled.
• Therapeutic inertia (TI) was observed in 68.4% of uncontrolled patients.
• Disagreement with physician's assessment and lower comorbidity burden were associated with TI.

Conclusions:

• Therapeutic inertia is prevalent in uncontrolled COPD patients.
• Patient-physician disagreement on disease control level increases likelihood of TI.
• Less frequent exacerbations may be linked to physician-reported good control and subsequent TI.