Provenance Certificate for Chronic Obstructive Pulmonary Disease (COPD) Pathway
Overview
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Editorial methodology
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References
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Contributors
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Disclaimers
Overview
This document describes the provenance of MidCentral District Health Board’s COPD pathways.
This localised pathway was last updated in May 2015.
One feature of the “Better, Sooner, More Convenient” (BSMC) Business Case, accepted by the Ministry of Health in 2010, was the
development of 33 collaborative clinical pathways (CCP).
The purpose of implementing the CCP Programme in our DHB is to:
• Help meet the Better Sooner More Convenient Business Case aspirational targets, particularly the following:
o Reduce presentations to the Emergency Department (ED) by 30%
o Reduce avoidable hospital admissions to Medical Wards and Assessment Treatment and Rehabilitation for over-65year-olds by 20%
o Reduce poly-pharmacy in the over-65-year-olds by 10%
• Implement a tool to assist in planning and development of health services across the district, using evidence-based clinical
pathways.
• Provide front line clinicians and other key stakeholders with a rapidly accessible check of best practice;
• Enhance partnership processes between primary and secondary health care services across the DHB.
To cite this pathway, use the following format:
Map of Medicine. Medicine. Thoracic Medicine. COPD. MidCentral View. Palmerston North: Map of Medicine; 2012 (Issue 1).
Editorial methodology
This care map was based on high-quality information and known Best Practice guidelines from New Zealand and around the world
including Map of medicine editorial methodology. It has been checked by individuals with front-line clinical experience (see Contributors
section of this document).
Map of Medicine pathways are constantly updated in response to new evidence. Continuous evidence searching means that pathways can
be updated rapidly in response to any change in the information landscape. Indexed and grey literature is monitored for new evidence, and
feedback is collected from users year-round. The information is triaged so that important changes to the information landscape are
incorporated into the pathways through the quarterly publication cycle.
References
This care map has been developed according to the Map of Medicine editorial methodology. The content of this care map is based on highquality guidelines and practice-based knowledge provided by contributors with front-line clinical experience. This localised version of the
evidence-based, practice-informed care map has been peer-reviewed by the CCP Executive Team and with stakeholder groups.
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Clinical Knowledge Summaries (CKS). Chronic obstructive pulmonary disease. July 2013. Newcastle upon Tyne: CKS; 2013.
Available from: http://cks.nice.org.uk/chronic-obstructive-pulmonary-disease
Global Initiative for Chronic Obstructive Lung Disease (GOLD). Global strategy for the diagnosis, management and prevention of
chronic obstructive pulmonary disease. Barcelona: GOLD; 2013. Available from:
http://www.goldcopd.org/uploads/users/files/GOLD_Report_2013_Feb20.pdf
National Clinical Guideline Centre. Chronic obstructive pulmonary disease: management of chronic obstructive pulmonary disease
in adults in primary and secondary care. London: National Clinical Guideline Centre; 2010. Available from:
http://www.nice.org.uk/nicemedia/live/13029/49425/49425.pd
Bott J, Blumenthal, Buxton M et al. Guidelines for the physiotherapy management of the adult, medical, spontaneously breathing
patient. Thorax 2009; 64: i1-i51. Available from: http://thorax.bmj.com/content/64/Suppl_1/i1.full
Contributors representing the Royal College of Physicians; 2011.
Practice-informed recommendation. London; 2011.
O'Driscoll BR, Howard LS, Davison et al. Guidelines for emergency oxygen use in adult patients. Thorax 2008; 63: vi1-68. Available
from: http://www.brit-thoracic.org.uk/Portals/0/Guidelines/Emergency%20oxygen%20guideline/THX-63-Suppl_6.pdf
Diagnosis and management of COPD in Māori and Pacific peoples. Best Practice Journal, 2012. BPJ: 43 – COPD in Maori and Pacific
people. Available from: http://www.bpac.org.nz/BPJ/2012/April/copd.aspx
British Thoracic Society (BTS). Clinical component for the home oxygen service in England and Wales. London: BTS; 2006. Available
from:
http://www.britthoracic.org.uk/Portals/0/Clinical%20Information/Home%20Oxygen%20Service/clinical%20adultoxygenjan06.pdf
Department of Health (DH). Medical Directorate. Respiratory Team. An outcomes strategy for COPD and asthma: NHS companion
document. London: DH; 2012. Available from: https://www.gov.uk/government/publications/an-outcomesstrategy-for-copd-andasthma-nhs-companion-document
The Asthma Foundation. COPD in New Zealand. 2012. Available from: www.asthmafoundation.org.nz
Auckland District Health Board. Pacifika health needs assessment. 2012. Available from:
http://www.adhb.govt.nz/healthneeds/Pacific%20health.htm
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Ministry of Health. A portrait of Health: Key results of the 2006/07 New Zealand Health Survey. Wellington: Ministry of Health;
2008
Bolton CE, Bevan-Smith EF, Blakey JD et al. British Thoracic Society guideline on pulmonary rehabilitation in adults. Thorax 2013;
68 Suppl 2: ii1-ii30. Available from:
http://www.britthoracic.org.uk/Portals/0/Guidelines/Pul%20Rehabilitation/Pulmonary_rehab_2013/pulmonary_rehab_final.pdf
Nannini LJ, Poole P, Milan SJ et al. Combined corticosteroid and long-acting beta2-agonist in one inhaler versus inhaled
corticosteroids alone for chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2013; CD006826. Available from:
http://www.ncbi.nlm.nih.gov/pubmed/23990350
Jones R, Price D, Chavannes N et al. GOLD COPD categories are not fit for purpose in primary care. The Lancet 2013; 1: e17.
Available from: http://www.thelancet.com/journals/lanres/article/PIIS2213-2600(13)70015-8/fulltext
Contributors representing the Royal College of Physicians; 2012.
National Institute for Health and Clinical Excellence (NICE). Generalised anxiety disorder and panic disorder (with or without
agoraphobia) in adults. Clinical guideline 113. London: NICE; 2011.
National Institute for Health and Clinical Excellence (NICE). Depression: The treatment and management of depression in adults.
Clinical guideline 90. London: NICE; 2009.
Curtis, J.R. Palliative and end-of-life care for patients with severe COPD. Eur Respir J 2008; 32: 796–803.
Conversation with Arohanui Hospice Palliative Care Team
Advance Care Planning: A guide for the New Zealand health care workforce. MOH: Wellington 2011
Ford ES, Li C et al. Associations between antioxidants and all-cause mortality among US adults with obstructive lung function. Br J
Nutr. 2014 Nov 28; 112(10): 1662-73.
Virtamo J, Taylor R et al. Effects of α-tocopherol and β-carotene supplementation on cancer incidence and mortality: 18 year post
intervention follow-up of the Alpa-Tocopherol, Beta-Carotene Cancer Prevention Study. International Journal of Cancer: 135, 178185 (2014).
Cortes-Jofre, M and Rueda J.R. et al. Drugs for Preventing Lung Cacner in Healthy People. Cochrane Database Syst Rev.
2012.http://www.ncbi.nlm.nih.gov/pubmed/23076895
Rautalahti M, Virtamo J et al. The effect of alpha-tocopherol and beta-carotene supplementations on COPD symptoms. Am J
Journal Respir Crit Care Med. 1997 Nov; 156 (5): 1447-52.
The Alpha-Tocopherol, Beta Carotene Cancer Prevention Study Group. The effect of Vitamin E and Beta Carotene on the Incidence
of Lung Canacer and other Cancers in Male Smokers. The New England Journal of Medicine. 1994. Volume 330.
Contributors
MidCentral DHB’s Collaborative Clinical Pathway editors and facilitators worked with clinical stakeholders such as front-line clinicians and
pharmacists to gather practice-based knowledge for its care maps.
The following individuals have contributed to this care map:
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Dr Aldoph Nanguzgambo, Respiratory Physician, MidCentral Health (Secondary Care Clinical Lead)
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Dr Michael Short, General Practitioner, Kauri Health Group (Primary Care Clinical Lead)
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Karen Lombard, Pharmacist, CPHO
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Julia Hince, Practice Nurse, Kauri Health Group
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Marina Lambert, Nurse Practitioner Respiratory Services, MCH
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Lindy Campbell, Community Respiratory Physiotherapist ,CPHO
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Sarah Dixon , Expert Respiratory Physiotherapist, MCH
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Lupe Kelekolio, Community Clinical Nurse: Long Term Conditions, CPHO
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Alaina Glue, Project Assistant, Collaborative Clinical Pathways (Editor)
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Leanne Bell - Clinical Nurse Specialist Acute Care Team, Health Care Development, MDHB
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Linda Dubbeldam, Senior Clinical Advisor, CPHO (Facilitator)
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Dr Greig Russell – Medical Director, Central PHO
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Denise White - Clinical Nurse Specialist (Lead) Community MidCentral Health
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Dr. Delamy Keall – General Practitioner, Tararua Health Group
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Kirsty Dunlop, Clinical Networks Project Manager
Other contributors:
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Fay Selby Law – Kaiarahi, Te Ohu Auahi Mutunga
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Suzanne Aitken – Community Dietician, CPHO
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Dr Alistair Watson – Respiratory Physician, MCH
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Jan Dewar - Nurse Director Medicine, Elder Health, Rehabilitation, District Nursing, MCH
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Kylie Bradley – Community Nurse, Tararua Health Group
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Sonja Dreyer – Senior Lecturer UCOL Kinetics
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Kim Fry, Director of Allied Health, MidCentral Health and Whanganui DHB
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Angela Verhoeven, Project Leader, CPHO
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Syed Zaman, Consultant Physician and RMO Director, MCH
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Aimee McGregor, CNS Respiratory, MCH
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Sharon Hancock, CNS Respiratory, MCH
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Susan Alexander – CNS Respiratory, MCH

Victoria Perry, NP Respiratory, MCH
Disclaimers
CCP Executive Team, MidCentral DHB
It is not the function of the CCP Executive Team, MidCentral DHB to substitute for the role of the clinician, but to support the clinician in
enabling access to know-how and knowledge. Users of the Map of Medicine are therefore urged to use their own professional judgement
to ensure that the patient receives the best possible care. Whilst reasonable efforts have been made to ensure the accuracy of the
information on this online clinical knowledge resource, we cannot guarantee its correctness and completeness. The information on the
Map of Medicine is subject to change and we cannot guarantee that it is up-to-date.