P9. Regular review

Regular review, with objective measures of lung function, health status (COPD Assessment Test [CAT]), consideration of referral to pulmonary rehabilitation and medication review, is recommended. This may reduce complications and the frequency or the severity (or both) of exacerbations and admissions to hospital.

An English RCT block randomised 18 general practices to integration of respiratory healthcare professionals (either respiratory physician or physiotherapist) into general practice to deliver annual COPD review compared with standard of care (GP lead annual COPD review) (Patel 2024) [evidence level II]. At 12 months, the integration of a respiratory healthcare professionals into the annual COPD review increased guideline concordant COPD care (>80% adherence to recommendations in their COPD care bundle), when compared with usual care (92.7% vs 70.1% p<0.001) (OR 4.14, 95% CI 2.14 to 8.03). Further studies with larger cohorts in other healthcare settings are required before this approach can be recommended.

Please see further discussion in section D.