Implementing GOLD Strategy for Patients with COPD in Primary Care

Abstract

Chronic Obstructive Pulmonary Disease (COPD) is a chronic, progressive illness frequently encountered by primary care clinicians. The Global Initiative for Chronic Lung Disease (GOLD) strategy offers the most robust evidence-based recommendations about the diagnosis and management of COPD. Understanding and utility of GOLD in primary care is limited. Goals of the project, to improve the quality of care for COPD patients, were based on Triple Aim Initiatives, COPD National Action Plan, and Healthy People 2020. The quality improvement project implemented a one-time staff and provider education about GOLD strategy in caring for COPD patients in a primary care setting. The quality improvement project also implemented a revised in-house spirometry testing workflow which incorporated GOLD strategy recommendations. Data outcomes were derived from chart audits and EHR metric reports for 120 COPD patients at a primary care clinic. Outcomes from the four-month project showed increased rates of GOLD strategy recommendations. There was an increase in the rates of spirometry confirmed diagnosis, increased rates of tobacco cessation counseling, increased rates of COPD Assessment Test performance, increased rates of tobacco cessation by COPD patients, and decreased rates of prescriptions for inhaled corticosteroids. The workflow was adopted into clinical practice at the site after completion of the implementation project.