X4. Uptake and impact of guidelines for exacerbations

Although there are many COPD guidelines around the world, there has been little evaluation of their uptake into clinical practice, or their impact on clinical outcomes.  A study of the compliance to COPD-X (Gerber 2016) recommendations in 381 COPD patients attending the EDs of two hospitals within one local Australian health service, has demonstrated moderately satisfactory results, with compliance to individual recommendations of the order of 74-90%, and to the whole list of recommendations of 49%, indicating  some room for further improvement.  Highest levels of compliance were seen in the most severe COPD cases.  This study did not show a reduction in LOS with greater compliance, however this analysis did not adjust for severity.