Do not do in COPD: consensus statement on overuse

• Published in: International journal of chronic obstructive pulmonary disease Vol. 13; pp. 451 - 463
• Main Authors: Villar-Álvarez, Felipe, Moreno-Zabaleta, Raúl, Mira-Solves, Jose Joaquin, Calvo-Corbella, Eduardo, Díaz-Lobato, Salvador, González-Torralba, Fernando, Hernando-Sanz, Ascensión, Núñez-Palomo, Sara, Salgado-Aranda, Sergio, Simón-Rodríguez, Beatriz, Vaquero-Lozano, Paz, Navarro-Soler, Isabel María
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01.01.2018; Dove Medical Press Ltd; Dove Medical Press
• Subjects: Activities of daily living; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; Clinical outcomes; consensus; COPD; General practitioners; Lung diseases; Medical personnel; Nurses; Original Research; patient safety; Patients; Physicians; Professionals; Qualitative research; quality assurance; Retirement benefits; Thoracic surgery; consensus; patient safety; quality assurance; COPD
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S151939

To identify practices that do not add value, cause harm, or subject patients with chronic obstructive pulmonary disease (COPD) to a level of risk that outweighs possible benefits (overuse). A qualitative approach was applied. First, a multidisciplinary group of healthcare professionals used the Metaplan technique to draft and rank a list of overused procedures as well as self-care practices in patients with stable and exacerbated COPD. Second, in successive consensus-building rounds, description files were created for each "do not do" (DND) recommendation, consisting of a definition, description, quality of supporting evidence for the recommendation, and the indicator used to measure the degree of overuse. The consensus group comprised 6 pulmonologists, 2 general practitioners, 1 nurse, and 1 physiotherapist. In total, 16 DND recommendations were made for patients with COPD: 6 for stable COPD, 6 for exacerbated COPD, and 4 concerning self-care. Overuse poses a risk for patients and jeopardizes care quality. These 16 DND recommendations for COPD will lower care risks and improve disease management, facilitate communication between physicians and patients, and bolster patient ability to provide self-care.