Abstract

The Belfast Health and Social Care Trust has the highest rate of respiratory admissions (1,582 per 100,000) and respiratory deaths (145 per 100,000) across NI. In August 2023, a Joint working project was agreed between NBF and AstraZeneca UK. To meet project demands, we collaborated with Screen Clinical Ltd for additional resource to fulfil the project. The project aimed to identify COPD patients with increased cardiopulmonary risk and minimise risk in primary care by focussing on implementing the 5 fundamentals of COPD care. In September 2023, clinical systems were interrogated across our 17 GP practices. Eligibility criteria was prioritising in terms of recent hospital admission, exacerbation and symptoms. Patients called for face-to-face pharmacist-led clinics ( Oct 23 - March 2024). Individualised assessments for each patient implemented the 5 fundamentals of COPD care.
Results : 572 patients with COPD and CVD, 388 had a history of an exacerbation, 378 invited to clinic, 303 attended clinic (80%), 221 had an exacerbation in last 12months (73%), 29 had been hospitalised (10%). 303 patients attended clinic, with established CVD and a history of an exacerbation. Of these patients 140 patients (46%) were treated with triple therapy, Of the 303 patients, 28 had no record of EOS count on their medical record, 80 (26%) had an EOS count of greater than 0.3, 21 (26%) were NOT on ICS, ,Of the 221 patients who had an exacerbation in the previous 12 months, 139 patients (63%) were not on triple therapy. 24 (11%) were not receiving any therapy.
In conclusion, it is critical to stratify COPD patients based on their symptoms, exacerbation history, and cardiopulmonary profile. By tailoring interventions accordingly, we can more effectively manage COPD and put primary prevention strategies within primary care