|Title:||Respiratory Advanced Nurse Practitioner Led Screening Service in an at Risk Population Attending an Emergency Department|
|Author(s):||P. O’Toole B. Magimairaj1 A. Deegan1 T.J. McDonnell N. Salter N. Ramphul S.L. O’Beirne|
|Institution:||St. Michael's Hospital|
|Poster:||Click to view poster|
|Category:||Asthma and COPD|
|Abstract:||Symptoms of chronic obstructive pulmonary disease (COPD) such as dyspnoea, cough and recurrent chest infections can be non-specific, contributing to diagnostic delays despite patient presentations to healthcare settings.|
Screening at risk populations results in earlier diagnosis and treatment. Our aim was to target an at risk population, screening them for pulmonary disease.
A retrospective chart review of at risk patients, defined as those with respiratory symptoms and >20 pack-year smoking history, referred by Emergency Department (ED) clinicians for Advanced Nurse Practitioner (ANP) assessment was performed.
Over 24 months n=61 referrals were received, 54% of which had no previous diagnosis of pulmonary disease. Among those without a prior diagnosis (n=35), n=3 (8.5%) had no significant disease, n=10 (28.5%) had normal spirometry but impairment to DLCO attributed to emphysema, n=2 (5.7%) had very severe COPD, n=2 (5.7%) severe COPD, n=3 (5.7%) moderate COPD, n=3 (8.5%) mild COPD and n=12 (34%) were diagnosed with asthma. Of those with a pre-existing respiratory disease (n=28), n=9 (28%) had a diagnosis change. ANP interventions included initiation of pharmacotherapy and crucial educational/preventative measures such as smoking cessation.
ANP-led ED COPD screening targeting symptomatic, at risk individuals has the potential to increase COPD diagnosis and improve patient care.
1. Lippiett K, Gillett K, Longstaff J, et al. Identifying undiagnosed COPD through searches of UK routine primarycare databases. European Respiratory Journal 2015; 46: Suppl. 59, PA338.
2. Kaplan A, Thomas M. Screening for COPD: the gap between logic and evidence. Eur Respir Rev 2017; 26: 160113
Conflict of Interest
The authors have no conflict of interest to declare.