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Educational interventions for health professionals managing chronic obstructive pulmonary disease in primary care

Cross A J et al. (2022)

Cochrane Database of Systematic Reviews - 10.1002/14651858.CD012652.pub2

Evidence Categories

  • Care setting: Primary care
  • Population group: Pre existing health condition
  • Intervention: Provider education
  • Outcome: Change in vaccination rates

Type of Evidence

Systematic Review

Aims

To review existing evidence for educational interventions delivered to health professionals managing COPD in the primary care setting.

Findings

Only four studies met the inclusion criteria of this evidence map (Markun et al., 2018; Morganroth et al., 2016; Lou et al., 2015; Zwar et al., 2016):

'Moderate‐quality evidence (downgraded due to risk of bias concerns) suggests that educational interventions for health professionals probably improve the proportion of patients with COPD vaccinated against influenza (three studies) and probably have little impact on the proportion of patients vaccinated against pneumococcal infection (two studies).'

In regards to the findings from the wider review, the authors state:

We identified 38 studies(22 cluster‐RCTs and 16 RCTs) involving 4936 health professionals (reported in 19/38 studies) and 71,085 patient participants (reported in 25/38 studies). Thirty‐six included studies evaluated interventions versus usual care; seven studies also reported a comparison between two or more interventions as part of a three‐ to five‐arm RCT design.

A range of simple to complex interventions were used across the studies, with common intervention features including education provided to health professionals via training sessions, workshops or online modules (31 studies), provision of practice support tools, tool kits and/or algorithms (10 studies), provision of guidelines (nine studies) and training on spirometry (five studies). Health professionals targeted by the interventions were most commonly general practitioners alone (20 studies) or in combination with nurses or allied health professionals (eight studies), and the majority of studies were conducted in general practice clinics.

 

Conclusions

The authors state:

The evidence of efficacy was equivocal for educational interventions for health professionals in primary care on the proportion of COPD diagnoses confirmed with spirometry, the proportion of patients with COPD who participate in pulmonary rehabilitation, and the proportion of patients prescribed guideline‐recommended COPD respiratory medications. Educational interventions for health professionals may improve influenza vaccination rates among patients with COPD and patient satisfaction with care. The quality of evidence for most outcomes was low or very low due to heterogeneity and methodological limitations of the studies included in the review, which means that there is uncertainty about the benefits of any currently published educational interventions for healthcare professionals to improve COPD management in primary care. Further well‐designed RCTs are needed to investigate the effects of educational interventions delivered to health professionals managing COPD in the primary care setting.