Does multimorbidity result in de-prioritisation of COPD in primary care?
Abstract The aim of this study was to describe factors associated with having COPD regularly reviewed in primary care by a nurse or physician and assess whether there was de-prioritisation for COPD in multimorbid patients. We defined de-prioritisation as not having at least one check-up by a physici...
| Main Authors: | , , , , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
Nature Portfolio
2023-01-01
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| Series: | npj Primary Care Respiratory Medicine |
| Online Access: | https://doi.org/10.1038/s41533-023-00326-x |
| _version_ | 1797952698495008768 |
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| author | Carolina Smith Mikael Hasselgren Christer Janson Marta A. Kisiel Karin Lisspers Anna Nager Hanna Sandelowsky Björn Ställberg Josefin Sundh Scott Montgomery |
| author_facet | Carolina Smith Mikael Hasselgren Christer Janson Marta A. Kisiel Karin Lisspers Anna Nager Hanna Sandelowsky Björn Ställberg Josefin Sundh Scott Montgomery |
| author_sort | Carolina Smith |
| collection | DOAJ |
| description | Abstract The aim of this study was to describe factors associated with having COPD regularly reviewed in primary care by a nurse or physician and assess whether there was de-prioritisation for COPD in multimorbid patients. We defined de-prioritisation as not having at least one check-up by a physician during a two-year period. Among 713 COPD patients in the Swedish PRAXIS study, 473 (66%) had at least one check-up during the study period (ending in 2014). Patients with check-ups were more likely to have three or more comorbid conditions (31.9% vs. 24.6%) and exacerbations (35.1% vs. 21.7%) than those without. Compared with those without comorbidity, those with three or more diagnoses had increased relative risk ratios (and 95% CI) for consultations discussing COPD with only a physician (5.63 (2.68–11.79)), COPD-nurse only (1.67 (0.83–3.37)) or both (2.11 (1.09–4.06)). COPD patients received more frequent check-ups considering COPD if they had comorbidity or a history of exacerbations. We found no evidence of de-prioritisation for COPD in multimorbid patients. |
| first_indexed | 2024-04-10T22:50:28Z |
| format | Article |
| id | doaj.art-749b66b59acd4bb2b3b323e0d51fd893 |
| institution | Directory Open Access Journal |
| issn | 2055-1010 |
| language | English |
| last_indexed | 2024-04-10T22:50:28Z |
| publishDate | 2023-01-01 |
| publisher | Nature Portfolio |
| record_format | Article |
| series | npj Primary Care Respiratory Medicine |
| spelling | doaj.art-749b66b59acd4bb2b3b323e0d51fd8932023-01-15T12:04:37ZengNature Portfolionpj Primary Care Respiratory Medicine2055-10102023-01-013311910.1038/s41533-023-00326-xDoes multimorbidity result in de-prioritisation of COPD in primary care?Carolina Smith0Mikael Hasselgren1Christer Janson2Marta A. Kisiel3Karin Lisspers4Anna Nager5Hanna Sandelowsky6Björn Ställberg7Josefin Sundh8Scott Montgomery9School of Medical Sciences, Faculty of Medicine and Health, Örebro UniversitySchool of Medical Sciences, Faculty of Medicine and Health, Örebro UniversityDepartment of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala UniversityDepartment of Medical Sciences, Occupational and Environment Medicine, Uppsala UniversityDepartment of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala UniversityNVS, Division of Family Medicine and Primary Care, Karolinska InstitutetClinical Epidemiology Division, Department of Medicine, Solna, Karolinska InstitutetDepartment of Public Health and Caring Sciences, Family Medicine and Preventive Medicine, Uppsala UniversityDepartment of Respiratory Medicine, Faculty of Medicine and Health, Örebro UniversityClinical Epidemiology Division, Department of Medicine, Solna, Karolinska InstitutetAbstract The aim of this study was to describe factors associated with having COPD regularly reviewed in primary care by a nurse or physician and assess whether there was de-prioritisation for COPD in multimorbid patients. We defined de-prioritisation as not having at least one check-up by a physician during a two-year period. Among 713 COPD patients in the Swedish PRAXIS study, 473 (66%) had at least one check-up during the study period (ending in 2014). Patients with check-ups were more likely to have three or more comorbid conditions (31.9% vs. 24.6%) and exacerbations (35.1% vs. 21.7%) than those without. Compared with those without comorbidity, those with three or more diagnoses had increased relative risk ratios (and 95% CI) for consultations discussing COPD with only a physician (5.63 (2.68–11.79)), COPD-nurse only (1.67 (0.83–3.37)) or both (2.11 (1.09–4.06)). COPD patients received more frequent check-ups considering COPD if they had comorbidity or a history of exacerbations. We found no evidence of de-prioritisation for COPD in multimorbid patients.https://doi.org/10.1038/s41533-023-00326-x |
| spellingShingle | Carolina Smith Mikael Hasselgren Christer Janson Marta A. Kisiel Karin Lisspers Anna Nager Hanna Sandelowsky Björn Ställberg Josefin Sundh Scott Montgomery Does multimorbidity result in de-prioritisation of COPD in primary care? npj Primary Care Respiratory Medicine |
| title | Does multimorbidity result in de-prioritisation of COPD in primary care? |
| title_full | Does multimorbidity result in de-prioritisation of COPD in primary care? |
| title_fullStr | Does multimorbidity result in de-prioritisation of COPD in primary care? |
| title_full_unstemmed | Does multimorbidity result in de-prioritisation of COPD in primary care? |
| title_short | Does multimorbidity result in de-prioritisation of COPD in primary care? |
| title_sort | does multimorbidity result in de prioritisation of copd in primary care |
| url | https://doi.org/10.1038/s41533-023-00326-x |
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