PRIMIS, was founded 20 years ago as part of the University of Nottingham’s School of Medicine. Our aim is to support the healthcare system to extract knowledge and value from primary care data, using this insight and information to help achieve better health outcomes across the UK.
We author many of the data specifications that support national data collection activities, including the seasonal vaccination uptake survey on behalf of Public Health England and have been involved in the validation of the QOF indicators. Over the past 20 years, we have delivered NHS sponsored services to primary care organisations, that have led to development in the use of electronic health records and to the improved quality of data held in the patient records today.
PRIMIS also produces tools that help practices develop a systematic approach to the identification, diagnosis and optimal management of patients with life-long conditions. Many of our tools are used on a regular basis in general practice and have gained endorsement from national NHS organisations, including the GRASP-COPD tool, which supports primary care practitioners with their case finding work and helps them improve patient management.
Why COPD
COPD is listed as the fifth biggest killer disease by NHS England, killing around 25,000 people a year. If we look wider, there are approximately 3 million people estimated to be living with the disease in the UK as a whole, however there are only 1.2 million recorded diagnosis. That leaves somewhere just shy of two million patients potentially missing appropriate treatment. *
This unfortunately often translates in patients needing more hospital visits. Studies suggest that between 10-34% of the 115,000 annual emergency admissions for acute exacerbation of COPD (in England) are in people whose COPD is undiagnosed. These patients are likely to have had significant disabling symptoms for some time. Acute admission for COPD exacerbations come with a 14% risk of death within 90 days, and all this could have been prevented by earlier diagnosis and proactive treatment.
The NICE Quality Standard and the Outcomes Strategy for COPD and Asthma recommend targeted case finding in those at higher risk of COPD**, this is where GRASP-COPD comes into the picture.
How does GRASP-COPD WORK
GRASP-COPD is a free, easy-to-use tool that assists GP practices to interrogate their clinical data, enabling them to improve patient outcomes, reduce costs and give the right treatment for patients with COPD.
The case finder element generates a list of their patients who may have a missing diagnosis code for COPD but also identifies and categorises those most at risk of developing the disease.
It helps practices find and review patients with COPD, enabling them to assess their work against both NICE and GOLD guidelines. To do so it sifts through patient data and looks for things such as COPD management checks, yearly review rates, patients with a self-management plan, pulmonary rehabilitation attendance, inhaler technique assessments and body mass index (BMI) recording rates, but also MRC dyspnoea score, COPD severity, smoking status, vaccination status and more.
Another useful function the ability to compare a patient's disease severity against their current treatment, helping to ensure that patients receive optimum care as well as bringing potential savings. It also allows to compare data with other practices both locally and nationally and the option to share aggregated data with their CCG.
Even though the tool was developed nearly ten years ago, it has been kept current and up-to-date with national guidelines, and has been adapted for use with various GP IT native system searches.
The tool has recently been translated into the SNOMED CT, and PRIMIS is one of the organisations at the forefront of understanding and development of this coding system in the UK.
GRASP-COPD has been free at the point of use for GP-practices since its launch and, thanks for funding from Boehringer Ingelheim Ltd, continues to be so.
Where to find GRASP-COPD
GRASP-COPD is available free to use for all GP practices in England, and a free membership of the PRIMIS Hub is required to obtain and use the tool. You can sign up at https://www.primis.nottingham.ac.uk/registration/
* https://www.nice.org.uk/guidance/qs10/chapter/introduction
** https://www.england.nhs.uk/wp-content/uploads/2014/02/rm-fs-6.pdf