Pragmatic Trial to Enhance Quality Safety, and Patient Experience in COPD

What this Trial Is About

Chronic obstructive pulmonary disease (COPD) affects over 26 million Americans and is a leading cause of death in the United States. Many patients do not receive the best treatments, partly because primary care providers (PCPs) manage most COPD patients and face competing demands. This research compares the effectiveness of pharmacist-led population management with pulmonary specialist-led management to improve COPD care through evidence-based recommendations delivered as electronic consultations (E-consults) to PCPs. The study randomly assigns PCPs at five medical centers to one of two groups: population management by clinical pharmacists or by pulmonary specialists. Both groups review patient panels using electronic health records to identify COPD patients and provide guideline-based recommendations through E-consults with unsigned orders for PCPs to accept, modify, or decline. This approach aims to improve treatment quality and patient outcomes in COPD management. Participants include PCPs and their COPD patients, who will be monitored for outcomes such as COPD exacerbations, pneumonia, hospitalizations, or death up to six months after intervention. Researchers will also assess quality of COPD care, patient quality of life using the Clinical COPD Questionnaire, acceptance of recommendations by PCPs, and costs incurred by patients and caregivers. The study will help determine if pharmacist-led care is as effective as pulmonologist-led care in managing COPD.

Pragmatic Trial to Enhance Quality Safety, and Patient Experience in COPD