EPIC (Enhancing Patient outcomes In COPD) (2019)

Swale CCG

Project Summary

The EPIC project was designed to improve patient care in COPD, with a particular focus on tackling inappropriate prescribing of inhaled corticosteroids (ICS). As long term use of ICS increases patient risk of GI side effects, osteoporosis and has been proven to increase the risk of pneumonia, in this vulnerable group of patients.

Respiratory experts were commissioned to review patients with a view to reducing any inappropriate prescribing of ICS, ensuring patients were treated according to GOLD and local guidelines, reducing the number of different inhalers patients use, to aid compliance, and to generally “cleanse” the COPD registers in Swale practices to allow better future management of this cohort of patients.

The respiratory experts altered medication accordingly, and each patient received a follow up review to ensure concordance to, and suitability of, these new inhaler regimes.

  • 8% of patients were found not to have COPD.
  • 32% had inhaler regime simplified to improve concordance
  • 30% were found not to need ICS and had this inhaler removed from therapy
  • 1% required referral for oxygen therapy
  • 11% required a chest X-ray to rule out a differential diagnosis
  • 3% required referral to a respiratory consultant
  • 43% required referral to Pulmonary Rehabilitation (PR)