ArticleNPJ primary care respiratory medicine2014
Improving outcomes for people with COPD by developing networks of general practices: evaluation of a quality improvement project in east London.
Article in NPJ primary care respiratory medicine, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 6 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 6 syntheses or guidelines pooled it, 27 citations in OpenAlex.
- Supporting referral to pulmonary rehabilitation from primary care: A systematic evaluation of interventions using the ERIC taxonomy.NPJ primary care respiratory medicine · 2026Pooled it
- A Systematic Review of the Effectiveness of Interventions to Promote Referral; Adherence; and Uptake of Pulmonary Rehabilitation for Patients with Chronic Obstructive Pulmonary Disease.International journal of chronic obstructive pulmonary disease · 2023Pooled it
- Interventions on health care providers to improve seasonal influenza vaccination rates among patients: a systematic review and meta-analysis of the evidence since 2000.Family practice · 2021Pooled it
- The bigger, the better? A systematic review on the impact of mergers on primary care organizations.European journal of public health · 2021Pooled it
- The impact of new forms of large-scale general practice provider collaborations on England's NHS: a systematic review.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Pooled it
- Interventions to increase referral and uptake to pulmonary rehabilitation in people with COPD: a systematic review.International journal of chronic obstructive pulmonary diseasePooled it
- Integrated care for chronic respiratory disease: a narrative review.European respiratory review : an official journal of the European Respiratory Society · 2026Review
- Structured Evaluation and Management of Patients with COPD in an Accredited Program.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2023Article
- Determining the influence of the primary and specialist network of care on patient and system outcomes among patients with a new diagnosis of chronic obstructive pulmonary disease (COPD).BMC health services research · 2022Article
- Referral of patients with chronic obstructive pulmonary disease to pulmonary rehabilitation: a qualitative study of barriers and enablers for primary healthcare practitioners.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
- Progress in using the electronic health record to improve primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020Article
- Improving coding and primary care management for patients with chronic kidney disease: an observational controlled study in East London.The British journal of general practice : the journal of the Royal College of General Practitioners · 2019Observational
- Article
- Improving care for advanced COPD through practice change: Experiences of participation in a Canadian spread collaborative.Chronic respiratory disease · 2018Review
- Barriers and facilitators to integrating primary and specialist healthcare in the United Kingdom: a narrative literature review.Future healthcare journal · 2018Review
- Building managed primary care practice networks to deliver better clinical care: a qualitative semi-structured interview study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2017Article
- Implementation of 'matrix support' (collaborative care) to reduce asthma and COPD referrals and improve primary care management in Brazil: a pilot observational study.NPJ primary care respiratory medicine · 2016Observational
- Explaining the link between access-to-care factors and health care resource utilization among individuals with COPD.International journal of chronic obstructive pulmonary disease · 2016Article
- Four patients with a history of acute exacerbations of COPD: implementing the CHEST/Canadian Thoracic Society guidelines for preventing exacerbations.NPJ primary care respiratory medicine · 2015Article
Corrections and comments
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Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
backgroundStructured care for people with chronic obstructive pulmonary disease (COPD) can improve outcomes. Delivering care in a deprived ethnically diverse area can prove challenging.
aimsEvaluation of a system change to enhance COPD care delivery in a primary care setting between 2010 and 2013 using observational data.
methodsAll 36 practices in one inner London primary care trust were grouped geographically into eight networks of 4-5 practices, each supported by a network manager, clerical staff and an educational budget. A multidisciplinary group, including a respiratory specialist and the community respiratory team, developed a 'care package' for COPD management, with financial incentives based on network achievements of clinical targets and supported case management and education. Monthly electronic dashboards enabled networks to track and improve performance.
resultsThe size of network COPD registers increased by 10% in the first year. Between 2010 and 2013 completed care plans increased from 53 to 86.5%, pulmonary rehabilitation referrals rose from 45 to 70% and rates of flu immunisation from 81 to 83%, exceeding London and England figures. Hospital admissions decreased in Tower Hamlets from a historic high base.
conclusionsInvestment of financial, organisational and educational resource into general practice networks was associated with clinically important improvements in COPD care in socially deprived, ethnically diverse communities. Key behaviour change included the following: collaborative working between practices driven by high-quality information to support performance review; shared financial incentives; and engagement between primary and secondary care clinicians.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.