Impact of omitting annual reviews for COPD on patient-reported care quality

<bold>Background:</bold> Regular clinical reviews of people with COPD provide an opportunity to optimize management and are recommended in guidelines. However, there is limited data about the relationship between having an annual review and other aspects of care quality. <bold>Method:</bold> Using data from 74,827 people with COPD completing the Asthma+Lung UK COPD Passport, between 2014 and 2022, we conducted adjusted logistic regression (adjusting for year) and compared receipt of key items of care between those reporting that they had had an annual review (65.3%) and those who did not (34.%). To further capture patient experience, we also analyzed 4,228 free text responses from the 2021 Asthma+Lung UK annual COPD survey to the question “What’s the one thing that could improve your COPD care?” <bold>Results:</bold> We found that absence of an annual review was associated with significantly worse COPD care across all domains studied. Particularly inhaler training (Yes: 80.8% vs No AR: 38.4%, Adjusted Odds Ratio (AOR): 8.18 95% CI, 7.89-8.47), having a written care plan (Yes AR: 89.6% vs No AR: 56.9%, AOR 6.68, 95% CI 6.35-7.05) and medication knowledge (Yes AR: 72.6% vs 33.6%, AOR: 5.73, 95% CI 5.51-5.96). Thematic analysis of the 2021 COPD survey responses identified three areas to improve care: 1) Access and support from healthcare services, 2) Improved treatment effectiveness, and 3) Interaction between COPD and the social environment. <bold>Discussion:</bold> Failure to deliver annual COPD reviews is associated with worse patient-reported experience of care quality. In parallel, patients express a desire for greater support and access to healthcare services.