Functional Patient-Reported Experience Measures as Quality Measure in COPD Care - a Cross Sectional Study in Swiss General Practice

Purpose: Care for chronic obstructive pulmonary disease (COPD) is complex and often lacking. We aimed to explore a set of functional patient-reported experience measures (PREMs) reflecting key elements of COPD care as a measure of quality of care from the patient perspective, and to explore associations of PREMs with patients’ demographic attributes. Patients and methods: We performed a multi-centered cross-sectional analysis among 136 patients with pre-diagnosed COPD in Swiss general practice. In a survey, patients specified which key elements of care they had experienced within the previous 12 months. We calculated rates of PREMs reported and performed regression analyses to assess for associations between patient characteristics and overall PREMs as well as individual PREMs. Results: Of 10 PREMs included in the analysis, patients experienced a median of 4 (IQR 1–7). The most frequently experienced PREMs were assessment of physical capability (n=122, 89.7%) and smoking cessation advice (n=53, 84.1% of active smokers). The least experienced PREMs were assessment of patient inhaler technique (n=36, 30.3%), education in exacerbation recognition (n=26, 19.1%), and exacerbation action plan (n=13, 9.6%). Patient characteristics were not associated with overall number of PREMs. However, we found patient characteristics associated with individual PREMs: both high exacerbation risk and male sex were positively associated with physical activity counseling (OR 5.1; CI 1.8–14.1 and OR 2.44; CI 1.01–5.9 respectively), age was positively associated with influenza vaccination (per ten years of age: OR 1.84; 95% CI 1.001–3.4) and time since COPD diagnosis was negatively associated with assessment of physical capability (OR 0.88; 95% CI 0.8–0.997). Conclusion: Assessment of functional PREMs for COPD care in general practice revealed potential targets for initiatives aiming to improve quality of care. Most importantly, only a minority of patients experienced education measures such as instructions of inhaler technique or exacerbation recognition, which might be of prognostic importance