To understand how well the causes of exacerbations of COPD are identified in routine clinical care and what the outcomes are following exacerbations, including repeat admissions in the following 12 months.
COPD is a common chronic lung disease, most often associated with long-term smoking and pollution. COPD is seen more frequently in poorer communities and those who have worked within heavy industries. Previously, white males were the most common group suffering with COPD, but recently COPD has become increasingly common in women and those from non-white communities. These groups have been under-represented in research studies.
COPD patients experience flares of symptoms called exacerbations. Exacerbations are defined as an increase in symptoms requiring treatment. They can be caused by viruses, bacteria or environmental factors like cold weather. Studies suggest a number of events badged as exacerbations are actually caused by other health conditions, such as muscle weakness, heart attacks or heart failure. Misdiagnosis can lead to inaccurate or inappropriate treatments. Less is known about exacerbations in women or non-white adults, and it is unclear whether they benefit from the same or different treatment approaches.
This project will look at routinely collected health data of patients admitted who have COPD, and any subsequent readmissions in the following 12 months. It will assess:
- How often a cause of the exacerbation is identified in routine care?
- How often people are readmitted after treatment and what for?
- Whether there are differences in the severity, cause or readmission of exacerbations in different groups – including the characteristics of patients with COPD. This includes their age, ethnicity, whether they come from poorer areas in the community (based on social deprivation scores linked to postcode) and how bad their lung disease was before the admission.
- Whether there is evidence of another cause for the symptoms experienced, such as heart disease or anxiety.
These analyses will begin to understand the impact and causes of COPD exacerbations across different patient groups, and inform whether COPD care pathways need to change.
This project has been discussed with people admitted to hospital with an exacerbation of COPD, some of these patients will continue to work with the researchers.
This project was supported unanimously by the PIONEER Data Trust Committee.
Nowaf Alobaidi, University of Birmingham