The following is a summary of “Analysis of the quality of e-Consultations in chronic obstructive pulmonary disease,” published in the February 2024 issue of Pulmonology by Dobaño, et al.

The quality of e-consultations for Chronic Obstructive Pulmonary Disease (COPD) remains uncertain, prompting the study to evaluate their quality, characterize referred patients from Primary Care (PC) to the Unit of Pulmonology, and compare accepted versus rejected cases.

The retrospective, observational study analyzed e-Consultations requested by PC for suspected COPD throughout 2022. Quality was assessed using a 12-variable scale (score 0–10).

Out of 384 e-Consultations, 167 (43.5%) led to face-to-face visits, while 217 (56.5%) were rejected. Accepted patients had significantly higher confirmations of COPD diagnostic suspicion (P = 0.042). Rejected patients provided more physical examination data (P = 0.015) but had better lung function. Mean referral quality was acceptable (5.6 ± 2.1); 121 (31.3%) were insufficient, 118 (30.5%) acceptable, 75 (19.4%) good, and 30 (7.8%) excellent. Quality was low in half of the variables analyzed (6/12); acceptable in 3, and good in another 3. The capacity of resolution of referrals was good (one e-Consultation) in 199 requests (66.1%); deficient (two e-Consultations) in 72 (23.9%), and poor (≥3 e-Consultations) in 30 (10%). Overdiagnosis occurred in 40.2% of cases (86/214 e-Consultations). The risk could be classified in 247 patients (64.3%; 135 low-risk, 90 high-risk).

While e-consultations can identify COPD severity levels with sufficient information, overall quality and resolution capacity were suboptimal, with a high overdiagnosis rate.

Reference: resmedjournal.com/article/S0954-6111(23)00402-X/abstract