A Simplified Algorithm for the Diagnosis, Treatment, and Management of COPD in Routine Primary Care Practice
Carlos Cabrera López,1 Enrique Mascarós,2 Angel Azpeitia,3 Elena Villarrubia4 1Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain; 2Consultorio Auxiliar Arquitecto Tolsá, Valencia, Spain; 3Esteve Pharmaceuticals, SA, Barce...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2020-12-01
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| Series: | International Journal of COPD |
| Subjects: | |
| Online Access: | https://www.dovepress.com/a-simplified-algorithm-for-the-diagnosis-treatment-and-management-of-c-peer-reviewed-article-COPD |
| _version_ | 1818360455919304704 |
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| author | Cabrera López C Mascarós E Azpeitia A Villarrubia E |
| author_facet | Cabrera López C Mascarós E Azpeitia A Villarrubia E |
| author_sort | Cabrera López C |
| collection | DOAJ |
| description | Carlos Cabrera López,1 Enrique Mascarós,2 Angel Azpeitia,3 Elena Villarrubia4 1Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain; 2Consultorio Auxiliar Arquitecto Tolsá, Valencia, Spain; 3Esteve Pharmaceuticals, SA, Barcelona, Spain; 4Health Outcomes Research Department, Advanced Outcomes Research, SL. Barcelona, SpainCorrespondence: Carlos Cabrera López Email ccablopn@gmail.comBackground: Diagnostic and treatment strategies for chronic obstructive pulmonary disease (COPD) vary greatly. Despite international efforts to standardize the management of COPD, two-thirds of primary care patients are not diagnosed, treated, or managed according to current evidence-based guidelines, probably because of the difficulty of applying these in routine practice. The aim of this study was to develop a simplified algorithm for diagnosing, treating, and managing COPD in primary care whose consistency, scientific relevance, and applicability to routine clinical practice met approval bct 3y family doctors (FDs) and pulmonologists.Methods: The algorithm was developed in a series of sequential phases, consisting of a preliminary meeting among group coordinators to design the initial structure, an input meeting with FDs and pulmonologists to refine and validate the proposal, an algorithm design stage, and a Delphi survey in which FDs and pulmonologists evaluated and approved the final version. A target of 75% or more was established for each of the 20 items in the Delphi survey in the FDs group as well as the pulmonologists group. It was estimated that at least two Delphi rounds would be needed to reach consensus.Results: In total, 118 physicians (75 FDs and 43 pulmonologists) participated in the Delphi process. Fourteen of the 20 items (70%) were approved in the first round. In the second round (in which 74 FDs and 42 pulmonologists participated), the remaining six items, which had been reformulated based on feedback from the first round, were approved, together with an additional question on the face validity of the algorithm as a whole. Dyspnea was positioned as the main determinant of treatment decisions in the new algorithm.Conclusion: According to the experts consulted, this new simplified algorithm for the diagnosis, treatment, and management of COPD in primary care is a clear, functional, and useful tool for routine practice and meets the requirements for the correct management of this condition.Keywords: COPD, primary care, management, treatment, Delphi technique, consensus |
| first_indexed | 2024-12-13T21:01:04Z |
| format | Article |
| id | doaj.art-1d11e10cef984c0498866aab826f8781 |
| institution | Directory Open Access Journal |
| issn | 1178-2005 |
| language | English |
| last_indexed | 2024-12-13T21:01:04Z |
| publishDate | 2020-12-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | International Journal of COPD |
| spelling | doaj.art-1d11e10cef984c0498866aab826f87812022-12-21T23:31:36ZengDove Medical PressInternational Journal of COPD1178-20052020-12-01Volume 153347335560385A Simplified Algorithm for the Diagnosis, Treatment, and Management of COPD in Routine Primary Care PracticeCabrera López CMascarós EAzpeitia AVillarrubia ECarlos Cabrera López,1 Enrique Mascarós,2 Angel Azpeitia,3 Elena Villarrubia4 1Hospital Universitario de Gran Canaria Dr. Negrín, Las Palmas de Gran Canaria, Spain; 2Consultorio Auxiliar Arquitecto Tolsá, Valencia, Spain; 3Esteve Pharmaceuticals, SA, Barcelona, Spain; 4Health Outcomes Research Department, Advanced Outcomes Research, SL. Barcelona, SpainCorrespondence: Carlos Cabrera López Email ccablopn@gmail.comBackground: Diagnostic and treatment strategies for chronic obstructive pulmonary disease (COPD) vary greatly. Despite international efforts to standardize the management of COPD, two-thirds of primary care patients are not diagnosed, treated, or managed according to current evidence-based guidelines, probably because of the difficulty of applying these in routine practice. The aim of this study was to develop a simplified algorithm for diagnosing, treating, and managing COPD in primary care whose consistency, scientific relevance, and applicability to routine clinical practice met approval bct 3y family doctors (FDs) and pulmonologists.Methods: The algorithm was developed in a series of sequential phases, consisting of a preliminary meeting among group coordinators to design the initial structure, an input meeting with FDs and pulmonologists to refine and validate the proposal, an algorithm design stage, and a Delphi survey in which FDs and pulmonologists evaluated and approved the final version. A target of 75% or more was established for each of the 20 items in the Delphi survey in the FDs group as well as the pulmonologists group. It was estimated that at least two Delphi rounds would be needed to reach consensus.Results: In total, 118 physicians (75 FDs and 43 pulmonologists) participated in the Delphi process. Fourteen of the 20 items (70%) were approved in the first round. In the second round (in which 74 FDs and 42 pulmonologists participated), the remaining six items, which had been reformulated based on feedback from the first round, were approved, together with an additional question on the face validity of the algorithm as a whole. Dyspnea was positioned as the main determinant of treatment decisions in the new algorithm.Conclusion: According to the experts consulted, this new simplified algorithm for the diagnosis, treatment, and management of COPD in primary care is a clear, functional, and useful tool for routine practice and meets the requirements for the correct management of this condition.Keywords: COPD, primary care, management, treatment, Delphi technique, consensushttps://www.dovepress.com/a-simplified-algorithm-for-the-diagnosis-treatment-and-management-of-c-peer-reviewed-article-COPDcopdprimary caremanagementtreatmentdelphi techniqueconsensus |
| spellingShingle | Cabrera López C Mascarós E Azpeitia A Villarrubia E A Simplified Algorithm for the Diagnosis, Treatment, and Management of COPD in Routine Primary Care Practice International Journal of COPD copd primary care management treatment delphi technique consensus |
| title | A Simplified Algorithm for the Diagnosis, Treatment, and Management of COPD in Routine Primary Care Practice |
| title_full | A Simplified Algorithm for the Diagnosis, Treatment, and Management of COPD in Routine Primary Care Practice |
| title_fullStr | A Simplified Algorithm for the Diagnosis, Treatment, and Management of COPD in Routine Primary Care Practice |
| title_full_unstemmed | A Simplified Algorithm for the Diagnosis, Treatment, and Management of COPD in Routine Primary Care Practice |
| title_short | A Simplified Algorithm for the Diagnosis, Treatment, and Management of COPD in Routine Primary Care Practice |
| title_sort | simplified algorithm for the diagnosis treatment and management of copd in routine primary care practice |
| topic | copd primary care management treatment delphi technique consensus |
| url | https://www.dovepress.com/a-simplified-algorithm-for-the-diagnosis-treatment-and-management-of-c-peer-reviewed-article-COPD |
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