1. Seasonal variability in clinical care of COPD outpatients: results from the Andalusian COPD audit
- Author
-
Ruth Ayerbe-García, Francisco García-Gil, Fernando Romero-Valero, María Abad Arranz, Antonio Hidalgo-Molina, Ricardo I. Aguilar-Pérez-Grovas, Dolores Pérez-Tejero, A. Soriano, Francisco González-Vargas, Laura Caballero-Ballesteros, José Luis López-Campos, Carmen Calero-Acuña, María Sánchez-Palop, Jose Calvo-Bonachera, Bárbara Hernández-Sierra, Adolfo Domenech, Macarena Arroyo-Varela, Francisco Casas-Maldonado, Juan J. Cruz-Rueda, [López-Campos,JL, Abad Arranz,M, Calero-Acuña,C] Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville. [López-Campos,JL, Calero-Acuña,C] CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid. [Romero-Valero,F, Hidalgo-Molina,A] Sección de Neumología, Hospital Puerta del Mar, Cádiz. [Ayerbe-García,R, Aguilar-Pérez-Grovas,RI] Servicio de Neumología, Hospital Juan Ramón Jiménez, Huelva. [García-Gil,F, Caballero-Ballesteros,L] Servicio de Neumología, Hospital Universitario Reina Sofía, Córdoba. [Casas-Maldonado,F, Sánchez-Palop,M] Servicio de Neumología, Hospital Universitario San Cecilio, Granada. [Pérez-Tejero,D, Segado Soriano,A] Sección de Neumología, Hospital Infanta Margarita, Cabra, Córdoba. [Calvo-Bonachera,J, Hernández-Sierra,B] Servicio de Neumología, Hospital Torrecárdenas, Almería. [Doménech,A, Arroyo-Varela,M] Servicio de Neumología, Hospital Regional Universitario de Málaga, Málaga. [González-Vargas,F, Cruz-Rueda, JJ] Servicio de Neumología, Hospital Universitario Virgen de las Nieves, Granada, Spain., and This study was funded by an unrestricted grant from Menarini, Spain
- Subjects
Male ,Multivariate analysis ,Time Factors ,España ,Pilot Projects ,Instituciones de atención ambulatoria ,Clinical practice ,Logistic regression ,Pulmonary Disease, Chronic Obstructive ,0302 clinical medicine ,quality of care ,Forced Expiratory Volume ,Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Epidemiologic Factors::Comorbidity [Medical Subject Headings] ,Odds Ratio ,Medicine ,Enfermedad pulmonar obstructiva crónica ,030212 general & internal medicine ,Lung ,Original Research ,Persons::Persons::Patients::Outpatients [Medical Subject Headings] ,COPD ,Medical Audit ,seasons ,Process Assessment, Health Care ,Pacientes ambulatorios ,General Medicine ,Middle Aged ,Comorbilidad ,Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Personal Satisfaction [Medical Subject Headings] ,Satisfacción personal ,Modelos logísticos ,Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Statistics as Topic::Confidence Intervals [Medical Subject Headings] ,Phenomena and Processes::Physical Phenomena::Time::Periodicity::Seasons [Medical Subject Headings] ,clinical practice ,Bronchodilator Agents ,Treatment Outcome ,Patient Satisfaction ,Intervalos de Confianza ,Female ,Seasons ,International Journal of Chronic Obstructive Pulmonary Disease ,Oportunidad relativa ,Estaciones del año ,Analytical, Diagnostic and Therapeutic Techniques and Equipment::Equipment and Supplies::Nebulizers and Vaporizers [Medical Subject Headings] ,03 medical and health sciences ,Estudios retrospectivos ,Patient satisfaction ,Administration, Inhalation ,Humans ,Diseases::Respiratory Tract Diseases::Lung Diseases::Lung Diseases, Obstructive::Pulmonary Disease, Chronic Obstructive [Medical Subject Headings] ,Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Statistics as Topic::Models, Statistical::Logistic Models [Medical Subject Headings] ,Aged ,Quality Indicators, Health Care ,Retrospective Studies ,Geographical Locations::Geographic Locations::Europe::Spain [Medical Subject Headings] ,Chi-Square Distribution ,business.industry ,Nebulizers and Vaporizers ,Quality of care ,Retrospective cohort study ,Odds ratio ,medicine.disease ,Volumen respiratorio forzado ,Confidence interval ,Phenomena and Processes::Circulatory and Respiratory Physiological Phenomena::Respiratory Physiological Phenomena::Pulmonary Ventilation::Forced Expiratory Volume [Medical Subject Headings] ,Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::Ambulatory Care Facilities [Medical Subject Headings] ,Logistic Models ,030228 respiratory system ,Nebulizadores y vaporizadores ,Spain ,Multivariate Analysis ,business ,Chi-squared distribution ,Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Statistics as Topic::Probability::Odds Ratio [Medical Subject Headings] ,Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective Studies [Medical Subject Headings] ,Demography - Abstract
Jose Luis López-Campos,1,2 Maria Abad Arranz,1 Carmen Calero-Acuña,1,2 Fernando Romero-Valero,3 Ruth Ayerbe-García,4 Antonio Hidalgo-Molina,3 Ricardo I Aguilar-Pérez-Grovas,4 Francisco García-Gil,5 Francisco Casas-Maldonado,6 Laura Caballero-Ballesteros,5 María Sánchez-Palop,6 Dolores Pérez-Tejero,7 Alejandro Segado Soriano,7 Jose Calvo-Bonachera,8 Bárbara Hernández-Sierra,8 Adolfo Doménech,9 Macarena Arroyo-Varela,9 Francisco González-Vargas,10 Juan J Cruz-Rueda10 1Unidad Médico-Quirúrgica de Enfermedades Respiratorias, Instituto de Biomedicina de Sevilla (IBiS), Hospital Universitario Virgen del Rocío/Universidad de Sevilla, Seville, 2CIBER de Enfermedades Respiratorias (CIBERES), Instituto de Salud Carlos III, Madrid, 3Sección de Neumología, Hospital Puerta del Mar, Cádiz, 4Servicio de Neumología, Hospital Juan Ramón Jiménez, Huelva, 5Servicio de Neumología, Hospital Universitario Reina Sofía, Córdoba, 6Servicio de Neumología, Hospital Universitario San Cecilio, Granada, 7Sección de Neumología, Hospital Infanta Margarita, Cabra, Córdoba, 8Servicio de Neumología, Hospital Torrecárdenas, Almería, 9Servicio de Neumología, Hospital Regional Universitario de Málaga, Málaga, 10Servicio de Neumología, Hospital Universitario Virgen de las Nieves, Granada,Spain Objectives: Clinical practice in chronic obstructive pulmonary disease (COPD) can be influenced by weather variability throughout the year. To explore the hypothesis of seasonal variability in clinical practice, the present study analyzes the results of the 2013–2014 Andalusian COPD audit with regard to changes in clinical practice according to the different seasons.Methods: The Andalusian COPD audit was a pilot clinical project conducted from October 2013 to September 2014 in outpatient respiratory clinics of hospitals in Andalusia, Spain (8provinces with more than 8 million inhabitants) with retrospective data gathering. For the present analysis, astronomical seasons in the Northern Hemisphere were used as reference. Bivariate associations between the different COPD guidelines and the clinical practice changes over the seasons were explored by using binomial multivariate logistic regression analysis with age, sex, Charlson comorbidity index, type of hospital, and COPD severity by forced expiratory volume in 1 second as covariates, and were expressed as odds ratio (OR) with 95% confidence intervals (CIs).Results: The Andalusian COPD audit included 621 clinical records from 9 hospitals. After adjusting for covariates, only inhaler device satisfaction evaluation was found to significantly differ according to the seasons with an increase in winter (OR, 3.460; 95% CI, 1.469–8.151), spring (OR, 4.215; 95% CI, 1.814–9.793), and summer (OR, 3.371; 95% CI, 1.391–8.169) compared to that in autumn. The rest of the observed differences were not significant after adjusting for covariates. However, compliance with evaluating inhaler satisfaction was low.Conclusion: The various aspects of clinical practice for COPD care were found to be quite homogeneous throughout the year for the variables evaluated. Inhaler satisfaction evaluation, however, presented some significant variation during the year. Inhaler device satisfaction should be evaluated during all clinical visits throughout the year for improved COPD management. Keywords: COPD, seasons, clinical practice, quality of care
- Published
- 2017