Assessing current COPD management and opportunities for optimisation in Dutch primary care using the COPDOptimiser website, a class IIa medical device: Preliminary results

Introduction: The IPCRG Research Needs Statement highlights the need for validated tools for primary care screening, diagnosis, and management. We developed the COPDOptimiser website, a class IIa medical device for healthcare providers, which guide consultations of patients with COPD based on the Global Initiative on Obstructive Lung disease (GOLD) guidelines. We aimed to assess the alignment of patients’ current COPD management with the 2024 GOLD recommendations and the opportunities for optimisation. Methods: The COPDOptimiser is used during routine consultations in the Netherlands by primary care nurses in patients with a physician diagnosis of COPD. COPDOptimiser input and output are collected, along with users’ and patients’ feedback collected through questionnaires and interviews. Data from patients enrolled between October and December in 2024 were analysed. Results: Sixteen primary care practices recruited 68 patients with COPD (mean age 70.3 (±8.7 SD) years; 57% male). Of these, 30% had experienced an exacerbation in the past year; 22% did not use a maintenance inhaler, 31% used a single bronchodilator, and 15% were on triple therapy. Figure 1 shows that in 65% of the cases, the COPDOptimiser recommended a change in current (inhaled) pharmacotherapy. In 49% of the cases, a referral to pulmonary rehabilitation was recommended. Vaccination was recommended for 30% (Influenza), 36% (pneumococcal), and 41% (Covid) of the patients. User feedback indicated that not all recommendations were followed by the primary care nurses (e.g., reducing ICS dose was discussed, but after shared decision making with the patient, the treatment was continued). Discussion: In the majority of patients, multiple treatment optimisations were identified, highlighting there are rooms for management improvement. Validated tools like the COPDOptimiser could aid and educate healthcare providers and support delivery of evidence-based COPD management in primary care. Funding: This study was supported by a sponsorship from AstraZeneca.