Specialty COPD care during COVID-19: patient and clinician perspectives on remote delivery

BMJ Open Respir Res. 2021 Jan;8(1):e000817. doi: 10.1136/bmjresp-2020-000817.


Introduction: The COVID-19 pandemic has impacted specialty chronic obstructive pulmonary disease (COPD) care. We examined the degree to which care has moved to remote approaches, eliciting clinician and patient perspectives on what is appropriate for ongoing remote delivery.

Methods: Using an online research platform, we conducted a survey and consensus-building process involving clinicians and patients with COPD.

Results: Fifty-five clinicians and 19 patients responded. The majority of clinicians felt able to assess symptom severity (n=52, 95%), reinforce smoking cessation (n=46, 84%) and signpost to other healthcare resources (n=44, 80%). Patients reported that assessing COPD severity and starting new medications were being addressed through remote care. Forty-three and 31 respondents participated in the first and second consensus-building rounds, respectively. When asked to rate the appropriateness of using remote delivery for specific care activities, respondents reached consensus on 5 of 14 items: collecting information about COPD and overall health status (77%), providing COPD education and developing a self-management plan (74%), reinforcing smoking cessation (81%), deciding whether patients should seek in-person care (72%) and initiating a rescue pack (76%).

Conclusion: Adoption of remote care delivery appears high, with many care activities partially or completely delivered remotely. Our work identifies strengths and limitations of remote care delivery.

Keywords: COPD exacerbations; inhaler devices; long-term oxygen therapy (LTOT).

Publication types

  • Consensus Development Conference
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Attitude of Health Personnel*
  • Attitude to Health
  • COVID-19
  • Delivery of Health Care / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Nurses
  • Patient Acceptance of Health Care
  • Patient Education as Topic*
  • Physical Therapists
  • Physicians
  • Practice Patterns, Nurses'
  • Practice Patterns, Physicians'*
  • Pulmonary Disease, Chronic Obstructive / physiopathology
  • Pulmonary Disease, Chronic Obstructive / therapy*
  • SARS-CoV-2
  • Self-Management*
  • Severity of Illness Index
  • Smoking Cessation*
  • Surveys and Questionnaires
  • Telemedicine / methods*
  • United Kingdom