Generating a consensus on an electronic patient record for COPD in Portugal: a Delphi study

Abstract

Aim: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality associated with high social and economic costs. An improvement in the epidemiological knowledge on the management of COPD is important to the delivery of health care services. This Delphi study was conducted to obtain a consensus about the clinical variables necessary to the management of COPD through the development and implementation of an electronic clinical record. This tool will provide support for routine consultations and will allow data extraction for clinical research. An open prospective research cohort of patients with COPD in primary care in Portugal will be created using this tool. The study aimed to reach a consensus on the relevant clinical variables for the management of COPD to be used in an electronic patient record. Method: An adapted Delphi method was implemented with a panel of 15 experts including Family Physicians and Primary Care Nurses. The research team developed an initial list of relevant clinical variables for the management of COPD. Each expert was asked to add new variables to that list. The final list of variables was considered independently by experts in 3 rounds of assessment of importance and periodicity of clinical record. The median value of the degree of importance for each variable from the previous round was presented to the experts for consideration. A consensus was considered as reached on a rate of 80% of agreement on the importance of each variable. Results: A list with 66 variables was considered by the expert’s panel for the level of importance and also for the periodicity of record. The final round provided a consensus of importance in 56 (85%) variables. The consensus included: 6 individual socio demographic variables, 16 clinical history variables, 16 specific COPD disease related variables, 12 COPD intervention variables, 6 health services related variables. From the list of 66 variables, 10 (15.2%) were discarded due to a low consensus rate (i.e. o 80%). These were mostly individual socio demographic and clinical history variables. Conclusion: A consensus on the most relevant clinical variables for the management of COPD and for research purposes has been established by a panel of experts based on the initial contribution of the researchers