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COPD care delivery pathways in five European Union countries: mapping and health care professionals’ perceptions

Authors Kayyali R, Odeh B, Frerichs I, Davies N, Perantoni E, D'arcy S, Vaes AW, Chang J, Spruit MA, Deering B, Philip N, Siva R, Kaimakamis E, Chouvarda I, Pierscionek B, Weiler N, Wouters EF, Raptopoulos A, Nabhani-Gebara S

Received 13 January 2016

Accepted for publication 31 May 2016

Published 14 November 2016 Volume 2016:11(1) Pages 2831—2838

DOI https://doi.org/10.2147/COPD.S104136

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Charles Downs

Peer reviewer comments 6

Editor who approved publication: Dr Richard Russell


Reem Kayyali,1 Bassel Odeh,1 Inéz Frerichs,2 Nikki Davies,3 Eleni Perantoni,4 Shona D’arcy,5 Anouk W Vaes,6 John Chang,3 Martijn A Spruit,6 Brenda Deering,7 Nada Philip,1 Roshan Siva,3 Evangelos Kaimakamis,8 Ioanna Chouvarda,8 Barbara Pierscionek,1 Norbert Weiler,2 Emiel FM Wouters,6 Andreas Raptopoulos,9 Shereen Nabhani-Gebara1

1Faculty of Science, Engineering and Computing, Kingston University, Kingston-Upon-Thames, UK; 2Department of Anaesthesiology and Intensive Care Medicine, University Medical Centre Schleswig-Holstein, Kiel, Germany; 3Chest Clinic and Research and Development, Croydon University Hospital, Croydon, UK; 4Pulmonary Clinic, AHEPA University Hospital, Thessaloniki, Greece; 5Department of Medicine, Royal College of Surgeons in Ireland, Dublin, Ireland; 6Research and Education, CIRO – Centre of Expertise for Chronic Organ Failure, Horn, the Netherlands; 7COPD Outreach, Beaumont Hospital, Dublin, Ireland; 8Medical School, Aristotle University, Thessaloniki, 9Research and Development, Exodus Information Technology SA, Athens, Greece

Background: COPD is among the leading causes of chronic morbidity and mortality in the European Union with an estimated annual economic burden of €25.1 billion. Various care pathways for COPD exist across Europe leading to different responses to similar problems. Determining these differences and the similarities may improve health and the functioning of health services.
Objective: The aim of this study was to compare COPD patients’ care pathway in five European Union countries including England, Ireland, the Netherlands, Greece, and Germany and to explore health care professionals’ (HCPs) perceptions about the current pathways.
Methods: HCPs were interviewed in two stages using a qualitative, semistructured email interview and a face-to-face semistructured interview.
Results: Lack of communication among different health care providers managing COPD and comorbidities was a common feature of the studied care pathways. General practitioners/family doctors are responsible for liaising between different teams/services, except in Greece where this is done through pulmonologists. Ireland and the UK are the only countries with services for patients at home to shorten unnecessary hospital stay. HCPs emphasized lack of communication, limited resources, and poor patient engagement as issues in the current pathways. Furthermore, no specified role exists for pharmacists and informal carers.
Conclusion: Service and professional integration between care settings using a unified system targeting COPD and comorbidities is a priority. Better communication between health care providers, establishing a clear role for informal carers, and enhancing patients’ engagement could optimize current care pathways resulting in a better integrated system.

Keywords: COPD, comorbidities, care delivery pathway, comparative analysis

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