IMPROVED COPD MANAGEMENT THROUGH A SERVICE COMBINING HEALTH FORECASTING WITH ANTICIPATORY CARE

The risk of exacerbation for COPD patients varies in time with environment, housing, social factors, physical and mental health.  Anticipatory Care aims to reduce the risk of exacerbation predicted by Health Forecasting, and prevent unscheduled NHS contacts.  In Winter 2004/05, the Met Office and NHS trialled a COPD Health Forecasting and Anticipatory Care service in 30 PCTs.

The Met Office issued twice-weekly forecasts of risk, driven by seasonal variation, temperature, infectious diseases and health surveillance, in categories: “average”, “above average”, “high”, “very high”.  These triggered evidence-based interventions by NHS staff to participating COPD patients stratified by previous hospital admissions.

Interventions were phone-calls to identify problems and emphasise steps patients can take to prevent exacerbations.  Each participating practice received training in Anticipatory Care based on NICE guidelines.

The forecasts were a catalyst for improving patient education, by up to 45%.  One large practice reduced COPD hospital admissions by 85%.  Patients admitted frequently in 2003/04 were not admitted in 2004/05.

The prevention of unscheduled NHS contact depends on targeting all COPD patients, especially when they are most at risk.  There is evidence that combining Health Forecasting with Anticipatory Care improves care through developing the patient pathway.

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