Table 2.

Clinical Decision Support Systems (CDSS) developed in Synergy-COPD for COPD management in an integrated care scenario.

1. Early diagnosis - COPD case finding program The suite of CDSS supports the regional deployment of a program of early COPD diagnosis targeting citizens at risk examined in pharmacy offices and non-diagnosed patients studied in primary care. Additional objectives of the program are to ensure high quality forced spirometry accessible across heathcare tiers, as well as prevention of over-diagnosis of COPD in elderly due to the GOLD diagnostic criteria [1].

2. Enhanced stratification of COPD patients It includes three families of CDSS with well differentiated objectives: i) enhance applicability of the 2011 GOLD Update criteria for COPD staging [1]; ii) facilitate off-line comparisons with other COPD staging criteria, namely: BODE, DOSE, ADO, etc...[18-21]; and, iii) enhanced stratification combining acquired knowledge in Synergy-COPD and consolidated findings from ECLIPSE [6].

3. Community-based integrated care program The suite of CDSS aims at supporting different integrated care services fostering the transfer of complexity from specialized care to the community with an active role of patients. The two programs being deployed are: i) sustainability of training-induced effects and promotion of physical activity; and, ii) management of patients under long-term oxygen therapy (LTOT). The two programs were assessed within NEXES [41,49], as part of the deployment of integrated care services in the health district of Hospital Clinic.