A 21-Practice Evaluation of an Asthma and COPD Quality Improvement Program

Area of Science:

• Respiratory Medicine
• Primary Care Quality Improvement
• Health Informatics

Background:

• Asthma and Chronic Obstructive Pulmonary Disease (COPD) management requires continuous quality improvement in primary care.
• Electronic medical records (EMR) offer potential for supporting clinical audits and quality initiatives.
• The Achieving Clinical Audits with Electronic Records (ACAER) program was developed to leverage EMR data for quality improvement in respiratory care.

Purpose of the Study:

• To evaluate the effectiveness of the ACAER program in supporting primary care providers.
• To assess the program's impact on quality improvement initiatives for asthma and COPD patients.
• To determine changes in exacerbation rates and maintenance treatment in high-risk respiratory patients.

Main Methods:

• Observational cohort study utilizing data from the Optimum Patient Care Research Database Australia (OPCRDA).
• Inclusion criteria: individuals aged ≥12 years with asthma or COPD, receiving therapy, and at high risk of exacerbation/hospitalization.
• Data sources: EMR, patient questionnaires, and practice evaluation reports.

Main Results:

• A significant reduction in exacerbation rates was observed post-intervention for high-risk asthma (74.8 to 32.4 per 1000 patient-months) and COPD (122.9 to 91.2 per 1000 patient-months) patients.
• Maintenance therapy changes occurred in 48.4% of high-risk asthma and 59.3% of high-risk COPD patients within the first year post-intervention.
• Pre-intervention exacerbation rates in high-risk asthma patients were increasing, but declined and stabilized post-intervention.

Conclusions:

• The ACAER program demonstrates potential in driving treatment modifications within primary care settings.
• The findings support the program's role in improving long-term outcomes for high-risk asthma and COPD patients.
• ACAER facilitates quality improvement initiatives by utilizing electronic health records for respiratory disease management.