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Does multimorbidity result in de-prioritisation of COPD in primary care?
Örebro University, School of Medical Sciences. Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden.ORCID iD: 0000-0002-2560-9563
Örebro University, School of Medical Sciences.ORCID iD: 0000-0003-4241-7851
Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden.
Department of Medical Sciences, Occupational and Environment Medicine, Uppsala University, Uppsala, Sweden.
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2023 (English)In: npj Primary Care Respiratory Medicine, E-ISSN 2055-1010, Vol. 33, no 1, article id 2Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to describe factors associated with having COPD regularly reviewed in primary care by a nurse or physician and assess whether there was de-prioritisation for COPD in multimorbid patients. We defined de-prioritisation as not having at least one check-up by a physician during a two-year period. Among 713 COPD patients in the Swedish PRAXIS study, 473 (66%) had at least one check-up during the study period (ending in 2014). Patients with check-ups were more likely to have three or more comorbid conditions (31.9% vs. 24.6%) and exacerbations (35.1% vs. 21.7%) than those without. Compared with those without comorbidity, those with three or more diagnoses had increased relative risk ratios (and 95% CI) for consultations discussing COPD with only a physician (5.63 (2.68-11.79)), COPD-nurse only (1.67 (0.83-3.37)) or both (2.11 (1.09-4.06)). COPD patients received more frequent check-ups considering COPD if they had comorbidity or a history of exacerbations. We found no evidence of de-prioritisation for COPD in multimorbid patients.

Place, publisher, year, edition, pages
Nature Publishing Group, 2023. Vol. 33, no 1, article id 2
National Category
Respiratory Medicine and Allergy
Identifiers
URN: urn:nbn:se:oru:diva-103178DOI: 10.1038/s41533-023-00326-xISI: 000913780400001PubMedID: 36641480Scopus ID: 2-s2.0-85146266296OAI: oai:DiVA.org:oru-103178DiVA, id: diva2:1729936
Funder
Swedish Heart Lung FoundationSwedish Asthma and Allergy AssociationBror Hjerpstedts stiftelse
Note

Funding agencies:

Regional Research Council, Central Sweden 

Centre for Clinical Research, Dalarna, Sweden 

Centre for Clinical Research, Värmland, Sweden

Available from: 2023-01-23 Created: 2023-01-23 Last updated: 2024-04-08Bibliographically approved

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Smith, CarolinaHasselgren, MikaelSundh, JosefinMontgomery, Scott

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