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Chronic obstructive pulmonary disease (COPD) Primary care

Eleanor L Axson, Jennifer K Quint, Mome Mukherjee, Hannah R Whittaker, Philip W Stone, Kate McLaren

Type
Disease or syndrome
ID
PH797
Version ID
2221
Valid event data range
01/01/2020 to 31/01/2021
Sex
Female/Male
Agreement Date
2021-11-08
Coding system
Read codes v2 CTV3 codes ICPC-2 codes SNOMED CT codes
Tags /Collections
BREATHE Phenotype Library

Definition

  • copd
  • Validation of Read Codes for the Identification of COPD in CPRDQuint et al. validated a set of Read codes for the identification of COPD in CPRD in 2014. Using diagnostic codes alone, the positive predictive value (PPV) was 86.5% (77.5–92.3%). Requiring a diagnostic code, spirometry measures, and specific medication increased PPV to 89.4% (80.7–94.5%) but reduced case numbers by 10%.

Implementation

These codes are not intended to be mandatory, but are to be used as a starting point for the identification of COPD in routine EHR. Each study may differ in the sensitivity and specificity of the coding required.

According to the National Institute for Health and Care Excellence (NICE) guidelines for the diagnosis of COPD, COPD should be suspected in patients over 35 years old who have a risk factor (typically smoking) and at least one symptom. It is therefore recommended that these codes are only utilised in an adult population at least 35 years old with a history of smoking.

https://www.nice.org.uk/guidance/ng115/chapter/Recommendations#diagnosing-copd

Use the following terms to find COPD codes in code browsers

Note: * is a wildcard indicating inclusion of any characters

Search terms:

*copd*

*chronic obstructive pulmonary disease*

*emphysema*

*airway obstruction*

*airway obstrucn*

*emphysematous*

*chronic obstructive airways*

*chronic obstructive*

Exclude terms:

"subcutaneous emphysema"


Publications

  • Publications in 2019 using validated Read codes from Quint et al. 2014

  • D. Stolz, Kostikas, K., Loefroth, E., Fogel, R., Gutzwiller, F. S., Conti, V., Cao, H., and Clemens, A., “Differences in COPD exacerbation risk between women and men: analysis from the UK Clinical Practice Research Datalink data”, Chest, 2019.

  • M. Pikoula, Quint, J. K., Nissen, F., Hemingway, H., Smeeth, L., and Denaxas, S., “Identifying clinically important COPD sub-types using data-driven approaches in primary care population based electronic health records”, BMC Med Inform Decis Mak, vol. 19, p. 86, 2019.

  • H. R. Whittaker, Mullerova, H., Jarvis, D., Barnes, N. C., Jones, P. W., Compton, C. H., Kiddle, S. J., and Quint, J. K., “Inhaled corticosteroids, blood eosinophils, and FEV1 decline in patients with COPD in a large UK primary health care setting”, Int J Chron Obstruct Pulmon Dis, vol. 14, pp. 1063-1073, 2019.

  • C. I. Bloom, Ricciardi, F., Smeeth, L., Stone, P., and Quint, J. K., “Predicting COPD 1-year mortality using prognostic predictors routinely measured in primary care”, BMC Med, vol. 17, p. 73, 2019.

  • D. Dedman, Coton, S. J., Ghosh, R. E., Meeraus, W., Crim, C., Harvey, C., Amelio, J., and Landis, S. H., “Treatment Patterns of New Users of Fluticasone Furoate/Vilanterol in Asthma and COPD in UK Primary Care: Retrospective Cohort Study”, Pulmonary Therapy, vol. 5, pp. 81-95, 2019.

  • J. D. Chalmers, Poole, C., Webster, S., Tebboth, A., Dickinson, S., and Gayle, A., “Assessing the healthcare resource use associated with inappropriate prescribing of inhaled corticosteroids for people with chronic obstructive pulmonary disease (COPD) in GOLD groups A or B: an observational study using the Clinical Practice Research Data”, Respir Res, vol. 19, p. 63, 2018.

  • Publications in 2019 using Read codes from QOF

  • P. Rockenschaub, Jhass, A., Freemantle, N., Aryee, A., Rafiq, M., Hayward, A., and Shallcross, L., “Opportunities to reduce antibiotic prescribing for patients with COPD in primary care: a cohort study using electronic health records from the Clinical Practice Research Datalink (CPRD)”, J Antimicrob Chemother, 2019.

  • Publications in 2020

  • Found articles with screening decisions can be found at:

  • https://www.zotero.org/groups/2751849/copd_search_for_codes/library

  • Publications in 2020 using validated Read codes from Quint et al. 2014

  • Axson et al. "Temporal Trends in the Incidence of Heart Failure among Patients with Chronic Obstructive Pulmonary Disease and Its Association with Mortality." 10.1513/AnnalsATS.201911-820OC

  • Bloom et al. "Inhaled Corticosteroid Treatment Regimens and Health Outcomes in a UK COPD Population Study." 10.2147/COPD.S241568

  • Kiddle et al. "Prediction of five-year mortality after COPD diagnosis using primary care records." 10.1371/journal.pone.0236011

  • Kositkas et al. "Clinical Impact and Healthcare Resource Utilization Associated with Early versus Late COPD Diagnosis in Patients from UK CPRD Database." 10.2147/COPD.S255414

  • Requena et al. "Feasibility of using Clinical Practice Research Datalink data to identify patients with chronic obstructive pulmonary disease to enrol into real-world trials." 10.1002/pds.5188

  • Schultze et al. "Risk of COVID-19-related death among patients with chronic obstructive pulmonary disease or asthma prescribed inhaled corticosteroids: an observational cohort study using the OpenSAFELY platform." 10.1016/S2213-2600(20)30415-X

  • Stone et al. "Predictors of Referral to Pulmonary Rehabilitation from UK Primary Care."10.2147/COPD.S273336

  • Whittaker et al. "Accelerated FEV1 decline and risk of cardiovascular disease and mortality in a primary care population of COPD patients." 10.1183/13993003.00918-2020

  • Whittaker et al. "Eligibility for Lung Volume Reduction Surgery in Patients With COPD Identified in a UK Primary Care Setting."10.1016/j.chest.2019.07.016

  • Whittaker et al. "Characteristics Associated with Accelerated Lung Function Decline in a Primary Care Population with Chronic Obstructive Pulmonary Disease."10.2147/COPD.S278981

  • Publications in 2020 using Read codes from QOF

  • Kerkhof et al. "Association between COPD exacerbations and lung function decline during maintenance therapy." 10.1136/thoraxjnl-2019-214457

  • Mehta et al. "COPD and asthma in patients with opioid dependency: a cross-sectional study in primary care."10.1038/s41533-019-0161-7

  • Rockenschaub et al. "Antibiotic Prescribing Before and After the Diagnosis of Comorbidity: A Cohort Study Using Primary Care Electronic Health Records." 10.1093/cid/ciz1016

  • Rockenschaub et al. "Antibiotic Prescribing Before and After the Diagnosis of Comorbidity: A Cohort Study Using Primary Care Electronic Health Records."10.1093/jac/dkz411

  • Publications in 2020 using Read codes from TargetCOPD (Jordan et al. 2016)

  • Dickens et al. "Accuracy of Vitalograph lung monitor as a screening test for COPD in primary care."10.1038/s41533-019-0158-2

  • Haroon et al. "Impact of COPD case finding on clinical care: a prospective analysis of the TargetCOPD trial."10.1136/bmjopen-2020-038286

  • Publications in 2020 using ICD-9/ICD-10 codes from Gershon et al. 2009

  • Baliunas et al. "Variability in patient sociodemographics, clinical characteristics, and healthcare service utilization among 107,302 treatment seeking smokers in Ontario: A cross-sectional comparison." 10.1371/journal.pone.0235709

  • Johnson et al. "Healthcare system encounters before COPD diagnosis: a registry-based longitudinal cohort study." 10.1136/thoraxjnl-2019-213554

  • Code repositories

  • ID- Cambridge COP087 - Repository- University of Cambridge Primary Care Unit - Description- CPRD @ Cambridge – [v1.0 ARCHIVED] – August 2017 (GOLD): COPD codelist: CPRD Cambridge created, based on the QOF2012 list. Likely to be sensitive as broad range of codes. (CPRDCAM_COP087_MEDCODES) - Publication- QOF 2012

  • ID- Cambridge COP151 - Repository- University of Cambridge Primary Care Unit - Description- CPRD @ Cambridge – Codes Lists (GOLD): COPD: List developed by Cambridge CPRD group, based on the QOF2012 list. Likely to be sensitive as broad range of codes. (COP151) - Publication- QOF 2012

  • ID- Cambridge COPD_COD - Repository- University of Cambridge Primary Care Unit - Description- CPRD @ Cambridge – Code Lists (QOFv44 Business Rules): QOF SNOMED -> CPRD Aurum (COPD: COPD_COD) - Publication- https://digital.nhs.uk/data-and-information/data-collections-and-data-sets/data-collections/quality-and-outcomes-framework-qof/quality-and-outcome-framework-qof-business-rules/quality-and-outcomes-framework-qof-business-rules-v44-2019-2020-october-2020-release

  • ID- LSHTM Data Compass 340 - Repository- LSHTM Data Compass - Description- Clinical code list - COPD codes - Publication-

  • ID- LSHTM Data Compass 859 - Repository- LSHTM Data Compass - Description- Clinical Codelist - Read codes for COPD - Publication-

  • ID- LSHTM Data Compass 1134 - Repository- LSHTM Data Compass - Description- Covariate Code List - COPD - Publication-

  • ID- LSHTM Data Compass 1600 - Repository- LSHTM Data Compass - Description- Clinical Code List - Zoster Comorbidity Read Codes - Publication-

  • ID- LSHTM Data Compass 1601 - Repository- LSHTM Data Compass - Description- Clinical Code List - Zoster Comorbidity Read Codes - Publication-

  • ID- LSHTM Data Compass 1682 - Repository- LSHTM Data Compass - Description- Clinical codelist - Chronic pulmonary disease codes - Publication-

  • ID- LSHTM Data Compass 2036 - Repository- LSHTM Data Compass - Description- Clinical codelist - Chronic Obstructive Pulmonary Disease read codes - Publication-

  • ID- LSHTM Data Compass 2037 - Repository- LSHTM Data Compass - Description- Clinical codelist - Chronic Obstructive Pulmonary Disease ICD-10 codes - Publication-

  • ID- Manchester Clinical Codes 1 - Repository- Manchester Clinical Codes - Description- QOF Business Rules v24 - Publication- QOF v24

  • ID- Manchester Clinical Codes 2 - Repository- Manchester Clinical Codes - Description- QOF Business Rules v5 - Publication- QOF v5

  • ID- Manchester Clinical Codes 5 - Repository- Manchester Clinical Codes - Description- Withdrawing Performance Indicators: Retrospective Analysis of General Practice Performance Under the UKs Quality and Outcomes Framework - Publication- https://doi.org/10.1136/bmj.g330

  • ID- Manchester Clinical Codes 6 - Repository- Manchester Clinical Codes - Description- Effect of financial incentives on incentivised and non-incentivised clinical activities: longitudinal analysis of data from the UK Quality and Outcomes Framework - Publication- https://doi.org/10.1136/bmj.d3590

  • ID- Manchester Clinical Codes 9 - Repository- Manchester Clinical Codes - Description- Glucose, blood pressure and cholesterol levels and their relationships to clinical outcomes in type 2 diabetes: a retrospective cohort study - Publication- https://doi.org/10.1007/s00125-014-3473-8

  • ID- Manchester Clinical Codes 21 - Repository- Manchester Clinical Codes - Description- Primary care consultation rates among people with and without severe mental illness: a UK cohort study using the Clinical Practice Research Datalink - Publication- http://dx.doi.org/10.1136/bmjopen-2015-008650

  • ID- Manchester Clinical Codes 26 - Repository- Manchester Clinical Codes - Description- Inequalities in physical co-morbidity: A longitudinal comparative observational study of people with severe mental illness in the UK - Publication- http://dx.doi.org/10.1136/bmjopen-2015-009010

  • ID- Manchester Clinical Codes 43 - Repository- Manchester Clinical Codes - Description- Recorded quality of primary care for patients with diabetes in England before and after the introduction of a financial incentive scheme: a longitudinal observational study - Publication- http://dx.doi.org/10.1136/bmjqs-2012-001033

  • ID- - Repository- OpenSAFELY Codelists - Description- Current COPD: Codelist indicating current COPD. - Publication-

Clinical Code List

Rows: 1
Code Description Jakobs et al., 2020 Lokke et al., 2020 Savran et al., 2020 Nies et al., 2021
R95 Chronic obstructive pulmonary disease Y Y Y Y
Rows: 183
Code Description SNOMED CT Concept ID SNOMED CT Description ID Read V2 Code BREATHE Chronic bronchitis BREATHE Emphysema BREATHE incident COPD BREATHE prevalent COPD BREATHE COPD exacerbations BREATHE recommended Cambridge COPD_COD (QOF v44) LSHTM Data Compass 1601 QOF v45 (2020-2021)
105519017 Chronic bronchitis 63480004 105519017 H31..00 Y Y Y Y Y Y Y
113497011 Centrilobular emphysema 68328006 113497011 H322.00 Y Y Y Y Y Y Y
11828571000006115 Bronchiolitis fibrosa obliterans 40100001 3636165018 Y
1222334016 Other specified chronic obstructive pulmonary disease 13645005 475431013 H3y..11 Y Y Y Y Y Y Y Y
1222335015 Chronic obstructive pulmonary disease NOS 13645005 475431013 H3z..11 Y Y Y Y Y Y Y Y
1230190015 MacLeod's unilateral emphysema 45145000 1230190015 H32y200 Y Y
123588010 Mucopurulent chronic bronchitis 74417001 123588010 H311.00 Y Y Y
12704691000006117 Interstitial emphysema 77690003 770361000006117 Y
139979010 Fetid chronic bronchitis 84409004 506053014 H311100 Y Y Y
1484924013 Chronic obstructive pulmonary disease monitoring 390891009 1484924013 66YB.00 Y Y Y Y Y Y
1484971019 Chronic obstructive pulmonary disease monitoring due 390941006 1484971019 66YD.00 Y Y Y Y Y Y
1488423019 Chronic obstructive pulmonary disease follow-up 394702007 1488423019 66YL.00 Y Y Y Y Y Y
1488424013 Chronic obstructive pulmonary disease annual review 394703002 1488424013 66YM.00 Y Y Y Y Y Y
1494601017 COAD follow-up 394702007 1494601017 66YL.12 Y Y Y Y Y Y
1573111000000115 Issue of chronic obstructive pulmonary disease rescue pack 718241000000107 1573111000000115 8BMW.00 Y
161781000006116 Sawyer - Jones syndrome 45145000 75284014 H32yz11 Y Y
1656601000006119 COPD patient unsuitable for pulmonary rehabilitation 1656601000006103 1656601000006119 Y
1683181000000112 Chronic obstructive pulmonary disease 3 monthly review 760601000000107 1683181000000112 66YB000 Y Y Y Y Y Y
1683221000000119 Chronic obstructive pulmonary disease 6 monthly review 760621000000103 1683221000000119 66YB100 Y Y Y Y Y Y
1699821000006113 At risk of chronic obstructive pulmonary diseas exacerbation 383611000000102 756761000000112 14OX.00 Y
1704531000006115 COPD patient unsuitable for pulmonary rehab - enh serv admin 371611000000107 1152601000000114 9kf0.00 Y
1704541000006113 COPD patient unsuitable for pulmonary rehabilitation 371611000000107 1152601000000114 9kf0.11 Y
1704551000006110 Referred for COPD structured smoking assessment 375851000000108 739301000000115 9kf1.11 Y
1704561000006112 Refer COPD structured smoking assessment - enhanc serv admin 375851000000108 739301000000115 9kf1.00 Y
1704571000006117 COPD structured smoking assessment declined - enh serv admin 375911000000102 739421000000116 9kf2.00 Y
1704581000006119 COPD structured smoking assessment declined 375911000000102 739421000000116 9kf2.11 Y
1724351000006112 Clinical COPD Questionnaire 1724351000006108 1724351000006112 Y
1763751000006117 GP out of hours notified of COPD care plan 1763751000006101 1763751000006117 Y
1771201000006116 Chronic obstructive pulmonary disease multidisciplinary review 1771201000006100 1771201000006116 Y Y Y Y Y Y
1771441000006118 COPD patient experience discussed 1771441000006102 1771441000006118 Y
1780380013 Chronic obstructive pulmonary disease monitoring by nurse 401184000 1780380013 66YS.00 Y Y Y Y Y Y
1780381012 Chronic obstructive pulmonary disease monitoring by doctor 401185004 1780381012 66YT.00 Y Y Y Y Y Y
1785171000006113 GP OOH service notified of COPD care plan 783631000000109 1752261000000117 9e03.00 Y
1788021000006116 Chronic obstructive pulmonary disease rescue pack not indicated 1788021000006100 1788021000006116 Y
1811661000006110 COPD self-management plan agreed 811961000000106 2117851000000118 661M300 Y
1811741000006117 COPD self-management plan review 810951000000101 2115731000000110 661N300