- CONQUEST is the first-of-its-kind collaborative ‘interventional’ Chronic Obstructive Pulmonary Disease (COPD) registry with an integrated quality improvement program tracking over 200,000 patients.
- The CONQUEST vision is to drive change in the management of patients at risk of COPD exacerbations by imbedding quality standards in routine primary care, providing the structure and support to affect changes in patient management.
Optimum Patient Care (OPC), in collaboration with AstraZeneca, has launched the Collaboration On Quality Improvement Initiative for Achieving Excellence in Standards for COPD Care (CONQUEST), a global quality improvement initiative in Chronic Obstructive Pulmonary Disease (COPD).
This patient-centric initiative will focus on tracking COPD patients at risk of exacerbations or acute respiratory events who are currently undertreated or undiagnosed. Driving change in the management of these patients will be supported and informed by the CONQUEST Global Steering Committee, comprising of 11 world-renowned leaders in the field of COPD, from four continents. The inaugural Global and National (both UK and US) Steering Committee meetings are being held virtually between August and December 2020.
Despite being a largely preventable disease, the global burden of COPD is high and remains a public health priority in the 21st century.1 Estimated to affect 384 million people globally, COPD is the third leading cause of death.2,3 The cost to the economy is enormous, over $100 billion/year in the US alone, with up to 75% of the total direct cost attributed to exacerbations.1,4 The impact on patients’ lives is also substantial, with COPD projected to be responsible for a loss of 45 million quality adjusted life years, 315 million exacerbations and 9 million deaths cumulatively in the US over the next 20 years, assuming current patterns of treatment and smoking rates.5
“The impact of COPD on patients’ lives necessitates the need to focus our efforts on those individuals, both diagnosed and undiagnosed, at risk of exacerbating and to intervene earlier in the COPD pathway to halt this disease in its tracks” explains Prof John Hurst (Global Steering Committee Member and Professor of Respiratory Medicine, University College London). “These patients are often hidden in plain sight in primary and secondary care and are at risk of accelerated lung function decline, reduced quality of life and death, so a more aggressive, proactive exacerbation prevention approach is warranted.”
CONQUEST will be delivered in two phases; the first phase will involve the development of quality standards (QS), implementation strategies and comparison of these QS with current practice in the UK and USA (initially). The second phase will incorporate a cluster randomized control trial program to investigate adherence to the QS and the impact of their implementation on COPD outcomes.
“CONQUEST is essentially a roadmap to improved quality of COPD care” says Prof David Price (OPC’s founder and CEO). “One of our big aims is to integrate information from patients at risk of future exacerbations and present it to clinicians in a way that drives targeted, risk-based assessment and treatment.’’
The registry will be ‘fed’ from local and global data sources and will hold anonymous data from over 200,000 primary care patients at risk of COPD, collected from electronic medical records. This data will be further supplemented through patient questionnaires and enhanced clinical assessments.
“At AstraZeneca we are committed to improving outcomes for patients with COPD” says Dr Gonzalo de Miquel, Vice President Global Medical Affairs, Respiratory and Immunology, AstraZeneca. “We are therefore proud to support CONQUEST that will help to transform the patient’s pathway by identifying those at risk of future exacerbations as well as working towards reducing lung function decline and, ultimately, halting disease progression and reducing the risk of death.”
CONQUEST will advocate for appropriate and early treatments to optimize outcomes. It will encourage follow-up with patients and healthcare providers to lock in behavior change and generate transformational evidence to measure treatment success. First findings will be announced in 2021.
- Criner RN, Han MK. COPD Care in the 21st Century: A Public Health Priority. Respir Care. 2018;63:591–600.
- World Health Organization: the top 10 causes of death. Available from: https://www.who.int/news-room/fact-sheets/detail/the-top-10-causes-of-death
- Global Initiative for Chronic Obstructive Lung Disease. Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease. 2020 report. Available from: https://goldcopd.org/wp-content/uploads/2019/11/GOLD-2020-REPORT-ver1.0wms.pdf
- Sin DD, Should COPD stand for ‘comorbidity-related obstructive pulmonary disease’? Eur Respir J. 2015;46:901-901.
- Zafari Z, Li S, Eakin MN, Bellanger M, Reed RM. Projecting long-term health and economic burden of chronic obstructive pulmonary disease in the United States. Chest. 2020.
Chronic obstructive pulmonary disease (COPD) is a group of progressive lung diseases. The most common are emphysema and chronic bronchitis. Emphysema slowly destroys air sacs in the lungs, which interferes with outward air flow. Bronchitis causes inflammation and narrowing of the bronchial tubes, which allows mucus to build up. Symptoms of COPD include frequent coughing or wheezing, excess mucus production, shortness of breath and trouble taking a deep breath. The top cause of COPD is tobacco smoking, but long-term exposure to chemical irritants can also lead to COPD. Approximately 384 million people around the world have COPD, but the number is likely much higher as >50% may be undiagnosed. There is no cure for COPD, but treatment can help ease symptoms, lower the chance of complications, and generally improve quality of life. However, key opportunities to modify the COPD pathway are often missed due to delayed diagnosis and treatment. For example, as many as 85% of COPD patients have a lower respiratory consultation in the 5 years before diagnosis, while the average age of maintenance therapy initiation is 68-71 years! Untreated, COPD can lead to a faster progression of disease, heart problems, and worsening respiratory infections. COPD has a huge impact on patients’ lives, limiting their daily activities (i.e. difficulty walking or climbing stairs), ability to work, engage in social activities and increasing the likelihood of hospital stays, having other chronic diseases (e.g. heart failure, diabetes, coronary heart disease), depression and poor quality of life.
About Optimum Patient Care Optimum Patient Care Ltd (OPC), specializes in delivering medical research and services to improve diagnosis, treatment and care of chronic diseases within family care and specialist practices, and has provided clinical services and supported real-life research for over 14 years. OPC drives a vision for inclusion of real-life data into all aspects of medical research while informing the translation of research into daily clinical practice via new technologies and clinical services. More information about OPC can be found at www.optimumpatientcare.org
Over the past decade, OPC has proven its expertise in both healthcare service provision, and the collection of data for ethically approved research purposes, globally. In the UK, OPC has established one of the largest primary care databases, called the Optimum Patient Care Research Database (OPCRD) which holds over eleven million anonymized electronic health records from patients in primary care (www.opcrd.co.uk) Globally, in collaboration with academic partners OPC has contributed to the delivery of several large-scale international registries including the iHARP database and the International Severe Asthma Registry (ISAR) (www.isaregistries.org).