Chronic Obstructive Pulmonary Disease Clinical Care Standard
This clinical care standard is being developed to describe best practice for assessing and managing Chronic Obstructive Pulmonary Disease (COPD), including exacerbations.
COPD exacerbations are associated with increased morbidity, mortality and healthcare costs, and are a major source of potentially preventable hospitalisations.
COPD is a serious chronic condition, affecting an estimated one in 13 Australians over the age of 40.[i] It is the leading cause of potentially preventable hospitalisations (PPHs) in Australia,[ii] and is associated with significant costs to the healthcare system. In 2018-2019, an estimated $935 million was spent on COPD, representing 21% of the disease expenditure on respiratory conditions in Australia.[iii]
Tobacco smoking is the most common risk factor for COPD - 47% of people with COPD are past smokers and 25% currently smoke.[iv], [v] Smoking cessation is one of the most effective ways to slow disease progression, reduce symptom severity and the risk of exacerbations.[iv]
Despite the availability of clinical guidelines to support the management of this condition, there is significant variation in health care for COPD in Australia. The Fourth Australian Atlas of Healthcare Variation identified up to 18-fold variation in hospitalisation rates for COPD between local areas.[vi] The rate for Aboriginal and Torres Strait Islander people was 4.8 times as high as the rate of other Australians. In addition, the Fourth Australian Report on Antimicrobial Use and Resistance in Human Health highlighted that almost 50% of all antimicrobial prescriptions for COPD in admitted patients are inappropriate.[vii]
Aims of the standard
The clinical care standard will address current gaps in clinical practice, providing a pathway of quality care for the management of COPD in community and acute settings, and the transitions of care between them.
The overall goals of the clinical care standard are to:
- Reduce hospitalisation rates for COPD by supporting best practice care for the prevention of COPD, and the optimisation of therapy to reduce the risk of exacerbations
- Reduce the inappropriate use of antibiotics for the management of COPD exacerbations, and support antibiotic prescribing in line with current best-practice guidelines.
Consultation and expert advice
Clinicians, consumers and healthcare services will be consulted during the development of the Standard, which will include a public consultation period. The Commission has established a Topic Working Group (TWG) to advise on content development for the standard. The TWG includes membership from individuals with relevant lived experience and clinical expertise including in general practice, respiratory medicine, infectious disease, emergency medicine, pharmacy, nursing, physiotherapy, and Aboriginal and Torres Strait Islander Health - from states and territories around Australia.
The main roles of the group are to:
- Provide expert advice on the development of the Standard and related guidance materials
- Provide ongoing guidance on the impact of the Standard on key stakeholders
- Acknowledge and take into account the perspectives of a broad range of stakeholders when providing advice to the Commission
- Advise the Commission on the scope and key components of care to be the focus of the Standard
- Advise the Commission on the key sources of evidence to inform the development of the Standard. This might include clinical practice guidelines, clinical standards, systematic reviews, evidence on current practice and quality improvement measures.
- Advise on the formulation of quality statements and supporting indicators
- Present potential strategies to the Commission that support the implementation of the Standard
- Actively support raising awareness of the Standard
- Advise the Commission on a review plan for the Standard, and support any associated revision as required
- Actively support consultation on new resources developed
- Provide advice on communication strategies to support new resources
- Support and promote communication with stakeholder organisations to which they belong, including professional organisations, peak bodies and health organisations, where relevant and appropriate.
For those who are consumers, a key role is to advise the Commission on matters relating to their experience - whether as a patient or carer - and provide this perspective during the development of the Standard.
All topic working group members are required to disclose financial, personal and professional interests that could, or could be perceived to, influence a decision made, or advice given to the Commission. Disclosures are managed in line with the Commission’s Policy on Disclosure of Interests.
A high-level summary of the activities and timeframes to deliver this clinical care standard are provided in the table below.
These timelines are subject to change.
|Project planning and background research||January - March 2023 (complete)|
|Establish Topic Working Group (TWG)||March - May 2023 (complete)|
|Meetings with TWG to define scope and draft quality statements||April 2023 – February 2024 (ongoing)|
|National consultation||November – December 2023|
|Approvals and endorsement processes||April – July 2024|
|Launch of the standard||Late 2024|
If you have any questions about this clinical care standard, email email@example.com