COPD care delivery pathways in five European Union countries: mapping and health care professionals’ perceptions

Background: COPD is among the leading causes of chronic morbidity and mortality in the European Union with an estimated annual economic burden of €25.1 billion. Various care pathways for COPD exist across Europe leading to different responses to similar problems. Determining these differences and the similarities may improve health and the functioning of health services. Objective: The aim of this study was to compare COPD patients’ care pathway in five European Union countries including England, Ireland, the Netherlands, Greece, and Germany and to explore health care professionals’ (HCPs) perceptions about the current pathways. Methods: HCPs were interviewed in two stages using a qualitative, semistructured email interview and a face-to-face semistructured interview. Results: Lack of communication among different health care providers managing COPD and comorbidities was a common feature of the studied care pathways. General practitioners/family doctors are responsible for liaising between different teams/services, except in Greece where this is done through pulmonologists. Ireland and the UK are the only countries with services for patients at home to shorten unnecessary hospital stay. HCPs emphasized lack of communication, limited resources, and poor patient engagement as issues in the current pathways. Furthermore, no specified role exists for pharmacists and informal carers. Conclusion: Service and professional integration between care settings using a unified system targeting COPD and comorbidities is a priority. Better communication between health care providers, establishing a clear role for informal carers, and enhancing patients’ engagement could optimize current care pathways resulting in a better integrated system. Keywords: COPD, comorbidities, care delivery pathway, comparative analysi

WELCOME project: What do stakeholders want? In depth analysis of COPD patients, carers and healthcare professional views

Chronic obstructive pulmonary disease is a growing health concern worldwide. Telehealth can facilitate integrated COPD care by providing an opportunity for remote monitoring, early diagnosis and clinical intervention. A design for a telehealth-based system called Wearable Sensing and Smart Cloud Computing for Integrated Care to COPD Patients with Co-morbidities (WELCOME) has been proposed. This study identifies patients', informal carers' and HCPs' acceptance of and requirements for the WELCOME system in four European countries: the United Kingdom (UK), Ireland, Greece and Netherlands

Exploring COPD care pathway in different EU countries

Background: Successful COPD management requires a multidisciplinary approach. Current evidence shows that improvement in quality of life and reduction in healthcare costs can be achieved by integrating care via telehealth. Maintaining adherence and lifestyle management is another important aspect of COPD follow-up. Objectives: This study is part of WELCOME EU project (www.welcome-project.eu). It aims to map current COPD care pathway in 5 European countries (Germany, Greece, Ireland, Netherlands & UK) and identify how telehealth can integrate it. Method: Healthcare professionals from 5 collaborative partners were interviewed using a qualitative, semi-structured 2 stages email interview. Results: Lack of communication among different healthcare providers managing COPD and co-morbidities is a common feature of the studied care pathways. GPs/family doctors are responsible for liaising between different teams/services, bar Greece where this is done through pulmonologists. Ireland and the UK are the only countries with services for patients at home to shorten unnecessary hospital stay. In all countries, the lifestyle management service provided is similar with no specific tools used to enhance patients' adherence. Furthermore, no specified role/training exists for informal carers (partners, family & friends). Conclusion: Service and professional integration between care settings using a unified system targeting COPD and co-morbidities is a priority. Better communication between healthcare providers, establishing a clear role for informal carers and enhancing patients' adherence could optimise current care pathways resulting in a better integrated system. This could be achieved using a patient-centred telehealth system

COPD care delivery pathways in five European Union countries: mapping and health care professionals' perceptions

BACKGROUND: COPD is among the leading causes of chronic morbidity and mortality in the European Union with an estimated annual economic burden of €25.1 billion. Various care pathways for COPD exist across Europe leading to different responses to similar problems. Determining these differences and the similarities may improve health and the functioning of health services. OBJECTIVE: The aim of this study was to compare COPD patients’ care pathway in five European Union countries including England, Ireland, the Netherlands, Greece, and Germany and to explore health care professionals’ (HCPs) perceptions about the current pathways. METHODS: HCPs were interviewed in two stages using a qualitative, semistructured email interview and a face-to-face semistructured interview. RESULTS: Lack of communication among different health care providers managing COPD and comorbidities was a common feature of the studied care pathways. General practitioners/family doctors are responsible for liaising between different teams/services, except in Greece where this is done through pulmonologists. Ireland and the UK are the only countries with services for patients at home to shorten unnecessary hospital stay. HCPs emphasized lack of communication, limited resources, and poor patient engagement as issues in the current pathways. Furthermore, no specified role exists for pharmacists and informal carers. CONCLUSION: Service and professional integration between care settings using a unified system targeting COPD and comorbidities is a priority. Better communication between health care providers, establishing a clear role for informal carers, and enhancing patients’ engagement could optimize current care pathways resulting in a better integrated system

An open access database for the evaluation of respiratory sound classification algorithms

Objective: Over the last few decades, there has been significant interest in the automatic analysis of respiratory sounds. However, currently there are no publicly available large databases with which new algorithms can be evaluated and compared. Further developments in the field are dependent on the creation of such databases. Approach: This paper describes a public respiratory sound database, which was compiled for an international competition, the first scientific challenge of the IFMBE’s International Conference on Biomedical and Health Informatics. The database includes 920 recordings acquired from 126 participants and two sets of annotations. One set contains 6898 annotated respiratory cycles, some including crackles, wheezes, or a combination of both, and some with no adventitious respiratory sounds. In the other set, precise locations of 10 775 events of crackles and wheezes were annotated. Main results: The best system that participated in the challenge achieved an average score of 52.5% with the respiratory cycle annotations and an average score of 91.2% with the event annotations. Significance: The creation and public release of this database will be useful to the research community and could bring attention to the respiratory sound classification problem.publishe