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COPD Patient Care Flow Sheet

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COPD Patient Care Flow Sheet
COPD Patient Care Flow Sheet

Patient Name (LAST, FIRST) Health Care # (i.e., BC PHN) Date of Initial Visit (DD/MM/YYYY)





Birth date (DD/MM/YYYY) Gender Phone Number (include Area Code) Height (cm)

 Male  Female

CO-MORBIDITIES ( alphabetized by row ) Annual Weight (kg)

 Alcohol Overuse  Asthma  Arthritis  Atrial Fib  CHF

 Cor pulmonale / PAH  CVA  Depression/Anxiety  Diabetes  GERD

 Hypertension  Hypoxemia  Insomnia  Ischemic Heart Disease Smoker  Yes  No

 Kidney Disease  Lipid Abnormality  Liver Disease  Obesity Ex-smoker since __________

 Obstructive Sleep Apnea  Osteoporosis  PVD  Rhinitis/Sinusitis



Bold = mandatory field = Yes / No / data / or date Baseline DATE OF VISIT (DD/MM/YYYY)



REVIEW EACH VISIT Date Date Date Date Date

DIAGNOSIS AND CLASSIFICATION

FEV1 % predicted

COPD Classification (see table 1 on reverse side)

PREVENTION

Date of annual flu vaccine?

Pneumococcal vaccine in past 5 years?

THERAPY

Has the patient stopped smoking?

Brief smoking interventions provided?

Referral to stop smoking program?

Short-acting beta2 agonist?

Anticholinergic?

Long-acting beta2 agonist?

ICS? (see table 3 on reverse side)

Theophylline?

S & S of chronic hypoxemia or obstructive sleep apnea?

Specialist Referral? (see table 4 on reverse side)

Call back / return visit in 3 or 6 months?

EDUCATION AND SELF-MANAGEMENT

Review pathophysiology, prognosis and treatment

Ask patient to set a physical activity goal/assess progress

Review medication use and side effects

Provide GPAC patient guide

Refer to Pulmonary Rehabilitation?(see table 2 on reverse)

EXACERBATIONS

Exacerbation Action Plan in place?

Date of last exacerbation?

Corticosteroids prescribed?



Version Date: November 22, 2006

Record the antibiotic name or class prescribed and

document rotation







Table 1. COPD Classification using Medical Research Dyspnea Scale (MRC) and/or Spirometry



COPD

MRC Spirometry Symptoms

Classification



Normal spirometry: FEV1 / FVC > = 0.7 and/or Asymptomatic smoker or ex-smoker or chronic

0-1 At risk

FEV1 > = 80% of predicted cough and sputum



SOB from COPD with strenuous exercise or when

2 Mild FEV1/FVC 1 exacerbation in the past 12 months.





Table 4.



When to consider specialist referral?



 The diagnosis is uncertain.

 There are signs and symptoms of hypoxemic or hypercarbic respiratory failure.

 The patient has the inability to cope due to social circumstances, anxiety, knowledge or complex/high

care needs.

 There are severe or recurrent exacerbations and treatment failure.

 The patient has severe COPD and disability requiring more intensive interventions.

 More intensive co-morbidity assessment and management is required.

Version Date: November 22, 2006

 A young patient with limited smoking history.

 Difficulty in assessing home oxygen or sleep disorders.









Version Date: November 22, 2006


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