Abstract Background and Aims Adherence to guideline-concordant care is sub-optimal in chronic obstructive pulmonary disease (COPD) management in China. This study aimed to assess the impact of implementing Quality Standard (QS) in Quality Improvement Program (QIP) on improving adherence to inhaled therapy and other treatment outcomes in China. Methods In this prospective, multi-center study-Quality Improvement Program (QIP; NCT05638646), 1055 COPD patients (CAT≥10) with a history of frequent exacerbations were enrolled from 40 hospitals (secondary hospital: 20, tertiary hospital: 20) across five regions (the east, north, west, south and central) in China. 40 sites were assigned to either the QS group (20 hospital, n = 524) or control group (usual care) (20 hospital, n = 531). The QS comprised structured training, checking, and supervision to improve clinical evaluation, intervention, and follow-up. Adherence to the QS was assessed every 12 weeks, with non-compliant centers receiving guidance for continuous improvement. Primary outcomes included inhaler therapy adherence, correct inhaler technique, non-pharmacological treatment, and quality of disease assessment. Results Baseline clinical characteristics were balanced between the QS and control groups. After 48 weeks, the proportion of patients maintaining inhaled therapy increased by 30.6% in the QS group versus 7.1% in the control group (P 0.05). During the follow-up, patients were more likely to report good compliance and to achieve a proportion of days covered (PDC) ≥70% in QS group (91.1%) compared to those in control group (77.2%) at 48 weeks (P 0.05). The rate of correct inhaler use improved from 56.0% to 90.7% (34.7% increment) in the QS group, compared to an improvement from 67.8% to 80.8% (13.0% increment) in the control group (P 0.05). Furthermore, the QS group had significantly higher rates of non-pharmacological treatment and smoking cessation education. Meanwhile, both groups maintained similarly high rates of acceptable-quality spirometry tests. Conclusions Implementation of QS within QIP was associated with improved adherence to inhaled therapy, better inhaler technique,and greater uptake of non-pharmacological care among patients with COPD. These findings support broader integration of QS to enhance COPD management. This abstract is funded by: AstraZeneca China
Dandan et al. (Fri,) studied this question.