Observational and Pragmatic Research Institute, Singapore, Singapore.
Optimum Patient Care, Cambridge, UK.
Int J Chron Obstruct Pulmon Dis. 2021 Aug 12;16:2301-2322. doi: 10.2147/COPD.S313498. eCollection 2021.
Chronic obstructive pulmonary disease (COPD) are managed predominantly in primary care. However, key opportunities to optimize treatment are often not realized due to unrecognized disease and delayed implementation of appropriate interventions for both diagnosed and undiagnosed individuals. The COllaboratioN on QUality improvement initiative for achieving Excellence in STandards of COPD care (CONQUEST) is the first-of-its-kind, collaborative, interventional COPD registry. It comprises an integrated quality improvement program focusing on patients (diagnosed and undiagnosed) at a modifiable and higher risk of COPD exacerbations. The first step in CONQUEST was the development of quality standards (QS). The QS will be imbedded in routine primary and secondary care, and are designed to drive patient-centered, targeted, risk-based assessment and management optimization. Our aim is to provide an overview of the CONQUEST QS, including how they were developed, as well as the rationale for, and evidence to support, their inclusion in healthcare systems.
The QS were developed (between November 2019 and December 2020) by the CONQUEST Global Steering Committee, including 11 internationally recognized experts with a specialty and research focus in COPD. The process included an extensive literature review, generation of QS draft wording, three iterative rounds of review, and consensus.
Four QS were developed: 1) identification of COPD target population, 2) assessment of disease and quantification of future risk, 3) non-pharmacological and pharmacological intervention, and 4) appropriate follow-up. Each QS is followed by a rationale statement and a summary of current guidelines and research evidence relating to the standard and its components.
The CONQUEST QS represent an important step in our aim to improve care for patients with COPD in primary and secondary care. They will help to transform the patient journey, by encouraging early intervention to identify, assess, optimally manage and followup COPD patients with modifiable high risk of future exacerbations.
慢性阻塞性肺疾病（COPD）主要在初级保健中进行管理。然而，由于未识别的疾病和延迟实施针对已诊断和未诊断个体的适当干预措施，往往错失了优化治疗的关键机会。COllaboratioN on QUality improvement initiative for achieving Excellence in STandards of COPD care（CONQUEST）是首个此类合作性、干预性 COPD 登记处。它包含一个综合质量改进计划，重点关注处于可改变且 COPD 加重风险较高的患者（已诊断和未诊断）。CONQUEST 的第一步是制定质量标准（QS）。QS 将嵌入常规初级和二级保健中，旨在推动以患者为中心、有针对性、基于风险的评估和管理优化。我们的目标是提供 CONQUEST QS 的概述，包括它们的制定过程以及将其纳入医疗保健系统的理由和证据。
QS 由 CONQUEST 全球指导委员会（包括 11 名在 COPD 专业和研究方面具有专长的国际知名专家）于 2019 年 11 月至 2020 年 12 月期间制定。该过程包括广泛的文献回顾、QS 草案措辞的生成、三轮迭代审查和共识。
制定了四项 QS：1）确定 COPD 目标人群，2）评估疾病并量化未来风险，3）非药物和药物干预，4）适当的随访。每项 QS 之后都有一个理由陈述，以及与标准及其组成部分相关的当前指南和研究证据的摘要。
CONQUEST QS 代表了我们在初级和二级保健中改善 COPD 患者护理的目标的重要一步。它们将通过鼓励早期干预来识别、评估、优化管理和随访具有未来加重高风险的可改变 COPD 患者，从而改变患者的治疗路径。
