Does multimorbidity result in de-prioritisation of COPD in primary care?

Author:

Smith CarolinaORCID,Hasselgren Mikael,Janson Christer,Kisiel Marta A.,Lisspers Karin,Nager Anna,Sandelowsky HannaORCID,Ställberg BjörnORCID,Sundh JosefinORCID,Montgomery Scott

Abstract

AbstractThe aim of this study was to describe factors associated with having COPD regularly reviewed in primary care by a nurse or physician and assess whether there was de-prioritisation for COPD in multimorbid patients. We defined de-prioritisation as not having at least one check-up by a physician during a two-year period. Among 713 COPD patients in the Swedish PRAXIS study, 473 (66%) had at least one check-up during the study period (ending in 2014). Patients with check-ups were more likely to have three or more comorbid conditions (31.9% vs. 24.6%) and exacerbations (35.1% vs. 21.7%) than those without. Compared with those without comorbidity, those with three or more diagnoses had increased relative risk ratios (and 95% CI) for consultations discussing COPD with only a physician (5.63 (2.68–11.79)), COPD-nurse only (1.67 (0.83–3.37)) or both (2.11 (1.09–4.06)). COPD patients received more frequent check-ups considering COPD if they had comorbidity or a history of exacerbations. We found no evidence of de-prioritisation for COPD in multimorbid patients.

Publisher

Springer Science and Business Media LLC

Subject

Public Health, Environmental and Occupational Health,Pulmonary and Respiratory Medicine

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