Observational studyRespiratory research2017
Variability in adherence to clinical practice guidelines and recommendations in COPD outpatients: a multi-level, cross-sectional analysis of the EPOCONSUL study.
Observational study in Respiratory research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
What it found
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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.
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Who cites it
17 citing papers in PubMed, 26 citations in OpenAlex.
- Trial
- A Real-World Evaluation of Therapeutic Inertia in Patients with Severe Uncontrolled Chronic Obstructive Pulmonary Disease.International journal of chronic obstructive pulmonary disease · 2026Observational
- Resources and Readmission for COPD Exacerbation in Pneumology Units in Spain: The COPD Observatory Project.Healthcare (Basel, Switzerland) · 2025Article
- Development and Validation of a Quantitative Score for the Criteria Clinical Control in Stable COPD Proposed in the Spanish COPD Guidelines (GesEPOC): Results of the EPOCONSUL Audit.Journal of clinical medicine · 2025Article
- Post-Acute Care Interventions in Patients Hospitalized Due to COPD Exacerbation Before and After Implementation of an Integrated Care Program.International journal of chronic obstructive pulmonary disease · 2025Article
- Characteristics and actions in high-risk COPD in unstable patients: The EPOCONSUL audit.PloS one · 2025Article
- Article
- Article
- Association of Patient and Primary Care Provider Factors with Outpatient COPD Care Quality.Chronic obstructive pulmonary diseases (Miami, Fla.) · 2022Article
- Long-Term Outcomes for Chinese COPD Patients After PCI: A Propensity Score Matched, Double-Cohort Study.Frontiers in cardiovascular medicine · 2022Article
- Step-Up and Step-Down Treatment Approaches for COPD: A Holistic View of Progressive Therapies.International journal of chronic obstructive pulmonary disease · 2021Review
- Compliance and Utility of a Smartphone App for the Detection of Exacerbations in Patients With Chronic Obstructive Pulmonary Disease: Cohort Study.JMIR mHealth and uHealth · 2020Article
- Highlights of an Expert Advisory Board on Acute Exacerbations of Chronic Obstructive Pulmonary Disease (AE-COPD) in Latin America.International journal of chronic obstructive pulmonary disease · 2020Article
- Effectiveness of an Intervention to Improve Management of COPD using the AUDIT Methodology: Results of the Neumo-Advance Study.Clinical drug investigation · 2019Article
- Observational
- Effect of a nurse-led integrated care intervention on quality of life and rehospitalisation in patients with severe exacerbation of COPD-a pilot study.Chronic respiratory diseaseArticle
- Solutions to Improve COPD Patients' Clinical Outcomes and Quality of Care: Recommendations From the CARABELA Initiative.Open respiratory archivesArticle
Corrections and comments
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Authors and funding
9 authors at 5 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClinical audits have reported considerable variability in COPD medical care and frequent inconsistencies with recommendations. The objectives of this study were to identify factors associated with a better adherence to clinical practice guidelines and to explore determinants of this variability at the the hospital level.
methodsEPOCONSUL is a Spanish nationwide clinical audit that evaluates the outpatient management of COPD. Multilevel logistic regression with two levels was performed to assess the relationships between individual and disease-related factors, as well as hospital characteristics.
resultsA total of 4508 clinical records of COPD patients from 59 Spanish hospitals were evaluated. High variability was observed among hospitals in terms of medical care. Some of the patient's characteristics (airflow obstruction, degree of dyspnea, exacerbation risk, presence of comorbidities), the hospital factors (size and respiratory nurses available) and treatment at a specialized COPD outpatient clinic were identified as factors associated with a better adherence to recommendations, although this only explains a small proportion of the total variance.
conclusionTo be treated at a specialized COPD outpatient clinic and some intrinsic patient characteristics were factors associated with a better adherence to guideline recommendations, although these variables were only explaining part of the high variability observed among hospitals in terms of COPD medical care.
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