COPD Case-Finding Tool Validated, Ready for Use in Primary Care

Use of the chronic obstructive pulmonary disease (COPD) case-finding tool, CAPTURE, in US primary care practice demonstrated ability to provide critical in-study information to help guide protocol adjustment based on unforeseen events and to clearly outline COPD diagnostic processes, according to the results of analysis presented at the American Thoracic Society (ATS) International Conference, held virtually from May 14 to May 19, 2021. Researchers conducted the CAPTURE validation study by using a multimethod qualitative approach to guide longitudinal assessments and to inform strategies for implementation of the CAPTURE tool.

Recognizing that the enhancement of COPD management should include optimal disease identification at the primary care level, the researchers performed a thorough qualitative review of the CAPTURE tool in US primary care practice. The CAPTURE validation study included workflow reviews, patient opinion surveys, case-based vignettes, clinician focus groups, and staff questionnaires to cohesively establish a robust real-world practice evaluation of COPD case-finding readiness.

A total of 196 adults without a COPD diagnosis from 82 separate US practices, as well as 114 primary care clinic staff were enrolled in the CAPTURE study from 7 US practice-based research networks that serve both urban and rural locales. Physician and patient responses were analyzed, including correlations according to clinician level and practice, as well as frequency. Overall, 10 practices participated in the focus groups that examined patterning, salience, and context of key discourse items. All of the responses received a priori codes regarding relevancy for CAPTURE implementation planning, diagnosis of COPD, CAPTURE and COPD education preferences, CAPTURE intra-office clinical communication, and COPD assessment options with respect to the COVID-19 pandemic.

More than 90% of the patients evaluated agreed that the CAPTURE tool was easy to read and to understand, without any difference in responses to questions administered via verbal vs written. In terms of medical staff, more than 90% of the physicians, nurses, nurse practitioners, physician assistants, and medical assistants surveyed concurred that the peak expiratory flow (PEF) testing component of the CAPTURE study could assist in pulmonary assessment. If COVID-19 pandemic public health concerns continue, all practices agreed that they would consider alternative PEF practices as part of in-person or telemedicine evaluations.

The investigators concluded that the results of this study demonstrate that with the CAPTURE operating characteristic validation ongoing among 5000 individuals from practices with wide demographic and geographic variability, the tool appears to be ready to be implemented into US primary care.

Reference

Brown R, Isaac S, Tapp H, et al. Chronic obstructive pulmonary disease assessment in primary care to identify undiagnosed respiratory disease and exacerbation risk (CAPTURE): multi-method qualitative findings support implementation readiness of a new COPD screening tool in primary care practice. Presented at: the American Thoracic Society (ATS) 2021 International Conference; May 14-19, 2021. Abstract A2276.