Felipe Villar-Álvarez , 1 , Raúl Moreno-Zabaleta 2 , Jose Joaquin Mira-Solves 3 , Eduardo Calvo-Corbella 4 , Salvador Díaz-Lobato 5 , Fernando González-Torralba 6 , Ascensión Hernando-Sanz 7 , Sara Núñez-Palomo 8 , Sergio Salgado-Aranda 9 , Beatriz Simón-Rodríguez 10 , Paz Vaquero-Lozano 11 , Isabel María Navarro-Soler 12
02 February 2018
To identify practices that do not add value, cause harm, or subject patients with chronic obstructive pulmonary disease (COPD) to a level of risk that outweighs possible benefits (overuse).
A qualitative approach was applied. First, a multidisciplinary group of healthcare professionals used the Metaplan technique to draft and rank a list of overused procedures as well as self-care practices in patients with stable and exacerbated COPD. Second, in successive consensus-building rounds, description files were created for each “do not do” (DND) recommendation, consisting of a definition, description, quality of supporting evidence for the recommendation, and the indicator used to measure the degree of overuse. The consensus group comprised 6 pulmonologists, 2 general practitioners, 1 nurse, and 1 physiotherapist.
In total, 16 DND recommendations were made for patients with COPD: 6 for stable COPD, 6 for exacerbated COPD, and 4 concerning self-care.