A predictive tool currently in development at the University of Birmingham in Birmingham, United Kingdom, has outperformed all existing COPD scores in determining which patients are most likely to experience a severe respiratory health event requiring hospital admission within two years.
According to a news release, the findings were part of a study testing the Birmingham Lung Improvement Studies Score (BLISS). The paper, “Prognostic Score for Predicting Respiratory Admissions Among Patients with Chronic Obstructive Pulmonary Disease in Primary Care: Development and Validation in Population Cohorts (Birmingham Lung Improvement Studies),” was published in BMJ.
The study included 1,894 patients with new and existing COPD from the BLISS cohort, 1,749 patients with moderate to severe COPD from the ECLIPSE cohort and 27,340 patients with COPD from the CRPD Aurium database.
The BLISS score includes six common measures easily collected by medical personnel:
- Age
- COPD Assessment Test (CAT) score measuring the impact on patients’ lives
- Forced expiratory volume in one second (FEV1) percentage predicted (a measurement of lung function)
- Body mass index
- A record of respiratory-related hospital admissions in the previous year
- Diagnosis of diabetes
Four of those variables are available in primary care records, while the other two are partially available but easy to collect, the authors noted.
The researchers found the BLISS score showed good performance in estimating individual risk of respiratory admission within two years in cohorts containing patients from different settings, geographic locations and COPD severity levels.
“Not everyone has the same risk of being hospitalized, so the BLISS score provides [medical professionals] and other clinicians with an evidence-based way to target effective innovations to those patients with the greatest risk,” said Paymané Adab, MD, MPH, senior author of the study and professor of public health at the University of Birmingham. “This has the potential to reduce severe exacerbations — and avoidable admissions which lead to higher costs — whilst also optimizing patients’ quality of life.”
Once high-risk patients are identified using the BLISS score, they can be directed toward targeted, intensive, personalized models of care, such as:
- Prioritized access to pulmonary rehabilitation
- More frequent clinical reviews or post-exacerbation follow-up
- Prescribing therapies for those most likely to benefit
- Access to integrated care services, community pharmacy support or digital monitoring
- Enhanced self-management plans and preventative support
The researchers said impact evaluations are now needed to fully study the use of the score in clinical care settings.
