Astma/COPD service

Objective A study of the effectiveness and functioning of an asthma/COPD service (AC service). Design Observational study. Method General practitioners (GPs) in the northern part of the Netherlands can refer patients with airway symptoms to the AC service, which was set up in 2007 by local pulmonologists, GPs and the primary care laboratory CERTE. Before the assessment, patients fill in three questionnaires at home: The Clinical COPD Questionnaire (CCQ), the Asthma Control Questionnaire (ACQ) and a medical history list. The laboratory assesses lung function and a physical examination is carried out. All data is sent via the Internet to a pulmonologist, who advises the GP on diagnosis and treatment via an information system. The pulmonologist can offer a followup service if required. For this publication we had access to data from 14,748 registered patients and 3721 followup consultations. Results The pulmonologist diagnosed 6201 (42%) patients with asthma, 2728 (19%) with COPD and 1039 (7%) with asthma/COPD overlap syndrome'. The pulmonologist advised that 940 patients (6%) should have a change in medication and reassessment after 3 months. 29/07/2016 Een astma/COPDdienst voor de huisartsenpraktijk 2/2 In this group, the number of unstable COPD patients (CCQ ≥ 1) dropped from 134 (67%) to 99 (50%). The number of patients with unstable asthma (ACQ ≥ 1.5) dropped from 245 (3%) to 137 (24%). For 1642 (11%) patients the pulmonologist advised no change in medication and the GP referred the patient for reassessment after 12 months. These patients were generally stable, with a slight improvement in smoking status, exacerbations and inhalation technique. Conclusion Approximately 60% of all patients with asthma or COPD in this region were assessed by the AC service at least once in the period 20072014. Advice on diagnosis and treatment given to the GP resulted in better patientrelated outcomes in both asthma and COPD patients.