Seasonal variability in clinical care of COPD outpatients: results from the Andalusian COPD audit

• DOI: 10.2147/copd.s121885
• Publication Date: 2017-03-05T20:47:49Z
• Authors: Jose Luis López-C...; Maria Abad-Arranz; Carmen Calero-Acuña; Fernando Romero-V...; Ruth Ayerbe-Garcia; Antonio Hidalgo-M...; Ricardo I Aguilar...; Francisco García-Gil; Francisco Casas-M...; Laura Caballero-B...; María Sánchez-Palop; Dolores Pérez-Tejero; Alejandro Segado; Jose Calvo-Bonachera; Bárbara Hernández...; Adolfo Doménech; Macarena Arroyo-V...; Francisco Gonzále...; Juan J Cruz-Rueda
• Keywords: Male; Medical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Statistics as Topic::Confidence Intervals; Pilot Projects; International Journal of Chronic Obstructive Pulmonary Disease; Diseases of the respiratory system; Medical Subject Headings::Health Care::Health Care Facilities, Manpower, and Services::Health Facilities::Ambulatory Care Facilities; Medical Subject Headings::Phenomena and Processes::Physical Phenomena::Time::Periodicity::Seasons; Pulmonary Disease, Chronic Obstructive; 03 medical and health sciences; 0302 clinical medicine; quality of care.; Medical Subject Headings::Health Care::Health Care Quality, Access, and Evaluation::Quality of Health Care::Health Care Evaluation Mechanisms::Statistics as Topic::Probability::Odds Ratio; Forced Expiratory Volume; Administration, Inhalation; Odds Ratio; COPD; Medical Subject Headings::Phenomena and Processes::Circulatory and Respiratory Physiological Phenomena::Respiratory Physiological Phenomena::Pulmonary Ventilation::Forced Expiratory Volume; Humans; 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; Lung; Original Research; Aged; Quality Indicators, Health Care; Medical Audit; seasons; Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Equipment and Supplies::Nebulizers and Vaporizers; Chi-Square Distribution; RC705-779; Nebulizers and Vaporizers; Process Assessment, Health Care; Medical Subject Headings::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::Epidemiologic Factors::Comorbidity; Middle Aged; Medical Subject Headings::Geographical Locations::Geographic Locations::Europe::Spain; clinical practice; Bronchodilator Agents; 3. Good health; 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; Logistic Models; Patient Satisfaction; Medical Subject Headings::Persons::Persons::Patients::Outpatients; Multivariate Analysis; Female; Medical Subject Headings::Psychiatry and Psychology::Behavior and Behavior Mechanisms::Behavior::Personal Satisfaction

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.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 (8 provinces 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).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.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.