Résumé
Background: COPD is the third leading cause of global mortality, with a prevalence estimated at 7.5% in France. In 2019, the HAS (French Health Authority) published a COPD care pathway guide aimed at improving patient management. The Avicenne multidisciplinary health center developed a care pathway (PS-BPCO) to better manage COPD patients and identify those at risk for COPD. Outcome: to assess the impact of the care pathway on COPD exacerbations and hospitalizations due to exacerbations. Secondary objectives included evaluating overall COPD patient management in accordance with HAS guidelines and assessing early COPD detection through spirometry in at-risk patients. Methods: retrospective monocentric intervention study (before/after). Patients over 40 years with COPD from the MSPU Avicenne in Cabestany (66) were included. Intervention: implementation of the PS-BPCO care pathway starting February 1, 2020, involving healthcare professional training and care coordination activities. Results: 87 COPD patients were included, with a mean age of 69 years. 21 patients (27.63%) experienced one or more COPD exacerbations during the 3-year follow-up post PS-BPCO, compared to 31 (35.63%) in the year before the intervention (p=0.827). 3 patients (3.95%) were hospitalized at least once after PS-BPCO, compared to 7 (8.05%) before the intervention. PS-BPCO significantly increased pneumococcal vaccination coverage (53% vs 32%), screening for comorbidities such as peripheral arterial disease (59% vs 36%), monitoring of weight (39 vs 29%), lung cancer screening by thoracic CT scan (80% vs 66%), and referral to cardiology consultation (85% vs 60%). Conclusion: while not demonstrating a significant effect on exacerbation occurrence, PS-BPCO improved key indicators of COPD patient management despite the COVID-19 pandemic. By adapting it to the needs of healthcare structures, PS-BPCO could be implemented in other settings and on larger territorial scales.