Practice Reference Number:



Patient Outcomes & Information Service

COPD Baseline Cluster Report

18/05/2010

Cluster:

Walthamstow West PBC

Cluster Reference Number:

WWP4

Report Number:

Baseline Report

Project Contact Name:

Sadhna Gujral

The Patient Outcomes & Information Service is provided by Innovex (UK) Ltd, funded as a service to medicine

by Allen and Hanburys, part of the GlaxoSmithKline Group of Companies

Cluster Aggregate Report

Cluster Baseline Data

This report considers the data reported from all subscribing practices at the same relative point in the programme regardless of the actual date of subscription (i.e. all similar baseline results are considered irrespective of the chronological sequence).

Cluster Totals

All practices that have chosen to include data in aggregate reports are included in the totals.

A total population size is only given when all practices have valid population figures.

|Cluster practices in report |Total COPD Cluster Population |Total Practice Population |COPD % Population |

|10 |453 |55858 |0.8% |

|Cluster practices in |Total Reviewed Last 12 |% Reviewed |Priority Patients |

|report |Months | |Identified* |

|10 |90 |20% |106 |

Cluster Practice Totals

Only practices that have chosen to include data in the comparison report are included in this section.

|Practices in this report|Practice Details |Practice Population |Practice COPD |Practice COPD % |

| | | |Population |Population |

|007305 |Dr A Patel |5937 |36 |0.6% |

|007380 |Wood Street Health Centre |4366 |23 |0.5% |

|007394 |Queens Road Medical Centre |5606 |35 |0.6% |

|028447 |Dr Shui Surgery |4493 |74 |1.6% |

|031789 |Higham Hill Surgery |3966 |37 |0.9% |

|045967 |Dr Siddiqui Surgery |2563 |16 |0.6% |

|307981 |The St James Practice |10443 |56 |0.5% |

|323334 |Dr Hayat Surgery |5609 |17 |0.3% |

|341572 |Forest Road Medical Centre |10225 |126 |1.2% |

|514010 |Brunner Road Medical Centre |2650 |33 |1.2% |

|Practices in this report|Total Patients Reviewed Last 12|% Patients Reviewed |Priority Patients |

| |Months | |Identified* |

|007305 |22 |61% |5 |

|007380 |0 |0% |0 |

|007394 |22 |63% |3 |

|028447 |5 |7% |26 |

|031789 |6 |16% |20 |

|045967 |5 |31% |0 |

|307981 |1 |2% |23 |

|323334 |12 |71% |2 |

|341572 |4 |3% |23 |

|514010 |13 |39% |4 |

* Priority Patients are defined in Appendix - Data Definitions

Cluster NICE overview - using Baseline Current Population

Long line shows position at the time of the current report.

Cluster Therapy Breakdown - Baseline population

COPD Baseline Practice Report

Table of Contents

Table of Contents 1

Introduction 2

1. Practice data quality 3

1.1. Total population – COPD 3

1.2. Data quality – COPD 3

1.3. COPD and co-morbidity data quality by severity (NICE using FEV1) 4

2. Practice profile – COPD 5

2.1. COPD register 5

2.2. Patients reviewed 6

3. Clinical analysis 7

3.1. A profile of COPD patients 7

3.1.1. Mild COPD: Total number of exacerbations in the last 12 months 7

3.1.2. Moderate COPD: Total number of exacerbations in the last 12 months 7

3.1.3. Severe COPD: Total number of exacerbations in the last 12 months 8

3.1.4. FEV1 % > 80%: Total number of exacerbations in the last 12 months 8

3.1.5. Unknown COPD: Total number of exacerbations in the last 12 months 8

3.2. Profile of breathlessness MRC scale 9

3.3. Current COPD drug therapy - as a % of severity population 10

3.4. Smoking status 11

3.5. Age profile 11

3.6. Body Mass Index 11

3.7. Blood pressure 11

4. Appendix – Data definitions 12

4.1. COPD population 12

4.2. Count of exacerbations L12M 12

4.3. Calculation of FEV1 % of predicted if record is missing. 12

4.4. List of abbreviations used for medicines: 12

4.5. The MRC scale: 12

4.6. Priority Patients 13

Introduction

1. The Patient Outcomes and Information System (POINTS) is an analysis and audit tool that allows you to focus on improving patient outcomes in your practice. As part of the POINTS service, you will receive the following:

1. A Baseline report, which contains an analysis of your total COPD population at the time of POINTS installation

2. Follow-up reports, which report on the progress of your COPD population

2. Over time, we will be comparing the progress of the COPD patients in your practice and we will be referring to the following populations:

1. Baseline: This is the baseline cohort, i.e. those patients that were included in your baseline analysis. To be included, a patient needs to registered and diagnosed at the time POINTS was installed

2. Baseline Current: This is the baseline cohort at the time of the follow-up report. Over time, your baseline cohort may become smaller as people leave your practice or change diagnosis

3. Population Current: This is the total COPD population at the time the follow-up report is run. This population may increase or decrease over time

3. We are comparing these three groups because we want to help you track

1. the progress of your baseline population so that you can assess the impact of your interventions

2. the progress of your total practice population so that you always know where to focus next

4. Audit and analysis can benefit your practice in several ways. POINTS, specifically, can help you with the following:

1. It helps you evaluate your structured management of COPD as recommended by NICE.

2. It allows you to evaluate the success of specific interventions

3. It allows you to identify areas for improvement.

5. POINTS is one of the tools and services that are provided by the Allen & Hanburys’ Respiratory Care Team (RCT). The RCT provides a non promotional service, committed to working with healthcare professionals to optimise the management of patients with COPD.

6. POINTS reports are generated by Innovex (UK) Limited.

Practice data quality

POINTS reports use data that is captured on your clinical system to provide an analysis of your baseline population as well as tracking patient progress over time. The quality of your POINTS reports, therefore, depends on the quality and completeness of your practice clinical data.

Below you will find an outline of your current data counts. Whenever there are gaps of 10% or more, the quality of your POINTS report may be affected. These areas have been highlighted in red.

We strongly encourage all POINTS customers to use the patient review templates that are provided as part of the POINTS service. These templates will ensure that you capture all data that is required for the production of quality reports.

1 Total population – COPD

|Population |Baseline Count |

|Total COPD population: |453 |

2 Data quality – COPD

|Number of COPD patients with: |Baseline |% |

|Spirometry – No record |134 |49% |

|FEV1 – No record |247 |55% |

|FEV1 – Old record |36 |8% |

|FVC – No record |303 |67% |

|FVC – Old record |97 |21% |

|FEV1/FVC >= 0.7 |77 |17% |

|Breathlessness – No Record |373 |82% |

|Smoking Status – No record |29 |6% |

|Current or ex-smokers – Old record |29 |6% |

|Current smokers with no Smoking Health Education |13 |5% |

|Inhaler Technique - No Monitoring |178 |39% |

|Influenza vaccination - No status |57 |13% |

|Pneumococcal vaccination - No status ever |128 |28% |

Notes:-

1. Values and percentages shown in red where percentage > 10% of total COPD population

2. Old records are >12 months - NICE (2004)

* FEV1/FVC >= 0.7 is outside the working definition of COPD - NICE (2004)

3 COPD and co-morbidity data quality by severity (NICE using FEV1)

Note: Table is for Population Current only.

Results as a percentage of severity population count

|COPD severity |MILD |MODERATE |SEVERE |FEV1 > 80%*** |No FEV1 |Cannot |

| | | | | | |calculate |

|  |  |  |  |  |  |  |

4 Moderate COPD: Total number of exacerbations in the last 12 months

[pic]

|Moderate COPD: exacerbations |No record |0 |1 |2 |3 |>3 |

5 Severe COPD: Total number of exacerbations in the last 12 months

[pic]

|Severe COPD: exacerbations |No record |0 |1 |2 |3 |>3 |

6 FEV1 % > 80%: Total number of exacerbations in the last 12 months

|FEV1 % > 80%*: exacerbations |No record |0 |1 |2 |3 |>3 |

*FEV1 % predicted > 80% is outside of the working definition of COPD - NICE (2004)

7 Unknown COPD: Total number of exacerbations in the last 12 months

|Unknown* COPD: exacerbations |No record |0 |1 |2 |3 |>3 |

*Unknown - FEV1 % predicted is missing or cannot be calculated

9 Profile of breathlessness MRC scale

[pic]

|COPD Severity |

|Unknown* |

|TOTAL COPD |Total Patients |SABA |SAMA |LABA |LAMA |ICS/LABA |

| | | | | | |combination |

Unknown = Not recorded

** Old record > 12 months

10 Age profile

The age range of defined patients at Baseline

|Age |Number of patients |% of COPD patients |

|0 - 19 |0 |0% |

|20 - 39 |7 |2% |

|40 - 59 |93 |21% |

|60+ |353 |78% |

|Total COPD patients |453 |100% |

11 Body Mass Index

Body Mass Index recordings at Baseline

|Body Mass Index |=30 |Unknown* |Total COPD patients |

|Number of patients |101 |103 |89 |160 |453 |

* Unknown = Not recorded or current record is more than 12 months old

12 Blood pressure

Blood pressure recordings at Baseline

|Blood pressure |< 130/80 | ................
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