Variation in patient pathways and hospital admissions for exacerbations of COPD: linking the National COPD Audit with CPRD data

Imperial College London

  • Run by Imperial College London, in collaboration with the Royal College of Physicians and Clinical Practice Research Datalink (CPRD).
  • Investigating how variations in clinical care and patient pathways affect hospital admissions for exacerbation of chronic obstructive pulmonary disease (COPD) across England.
  • Will use linked data from the National COPD Audit and the Clinical Practice Research Datalink (CPRD) primary care data.
  • The research will be completed by late 2019.

Most people with chronic obstructive pulmonary disease (COPD) experience episodes of worsening of respiratory symptoms; called ‘exacerbations’. They affect the person’s quality of life and lead to frequent hospital admissions.

COPD exacerbations are the second most common cause of emergency admission to hospital in adults in the UK. Although some patients have exacerbations that mean they have to be admitted to hospital (for example patients with respiratory failure requiring oxygen); other hospitalisations are potentially avoidable.

The National COPD Audit is a continuous audit of almost all English hospital admissions for COPD exacerbations. It contains detailed information on clinical features associated with these admissions, and the data are linked with Hospital Episode Statistics data. However, there is currently no link with primary care data, which means the patient’s journey before and after hospital admission can’t be analysed.

This project from Imperial College London will involve linking this audit data with primary care data on COPD from Clinical Practice Research Datalink (CPRD). This will enable the whole patient pathway to be investigated, including visits to primary care before admission to hospital, medications that have been prescribed, and previous exacerbations.

Through the resulting linked dataset, the project team will explore how the management of patients with COPD and patient pathways vary across England, and how this variation relates to hospital admissions for COPD exacerbations.

There is significant geographical variation across England with regards to hospital admissions for COPD exacerbations. Some of this may be due to patient factors, but some may be due to health system factors such as ease of access to primary care. This novel data linkage work will help answer questions around this variation and what steps could be taken to provide better, more consistent care for COPD patients.

Contact information

For more information about this project, please contact Dr Jennifer Quint, Clinical Senior Lecturer in Respiratory Epidemiology, Imperial College London.

About this programme

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