CONQUEST-ADVANCE: Achieving proDuctiVe implementAtioN of CONQUEST Quality Standards in COPD Care

Year: 2026

Type: article

Abstract: Background: Integrated COPD management has improved outcomes for patients with diagnosed COPD. The CONQUEST Quality Improvement Program aims to improve the diagnosis and management for patients with potential and diagnosed modifiable high-risk (MHR) COPD, defined as those with a history of exacerbations and opportunities for treatment optimization. Methods: Utilizing the CONQUEST registry and Optimum Patient Care (OPC) Research Database, this observational cohort analysis assessed changes in quality indicator attainment over 12 months among potentially undiagnosed, newly diagnosed and already diagnosed patients with MHR COPD in exposed and matched usual care (UC) general practices. In exposed practices, newly diagnosed and already diagnosed patients were restricted to those receiving OPC-led CONQUEST clinics. Outcomes were compared using difference-in-difference generalized linear models with overlap propensity weighting. Findings: From 168 UK practices, we identified 113,574 potentially undiagnosed (59,706 exposed, 53,868 UC), 2787 newly diagnosed (1448 exposed of which 252 attended OPC clinics, 1339 UC) and 38,054 already diagnosed (21,670 exposed of which 392 attended OPC clinics, 16,384 UC). Potentially undiagnosed patients in exposed practices were more likely to subsequently receive a spirometry-confirmed COPD diagnosis (1.0% vs 0.6%; adjusted ratios-of-risk-ratios [ARRR]:1.55, 95% CI: 1.19-2.01) compared to UC. Initiation or step-up to guideline-appropriate inhaled therapy was more likely among OPC-supported patients in exposed practices for newly diagnosed (96.4% vs 55.7%; ARRR: 1.71, 95% CI: 1.41-2.06) and already diagnosed (91.6% vs 39.8%; ARRR: 1.94, 95% CI: 1.77-2.1212) versus unsupported UC. Interpretation: CONQUEST is associated with measurable improvements in quality indicator attainment aligned with guideline-recommended identification and management of COPD, including higher rates of spirometry-confirmed COPD diagnosis and treatment optimization. Future randomized trials will evaluate if this translates into improved outcomes including reduced exacerbations and hospitalizations.

Source: Pragmatic and Observational Research

DOI: 10.2147/por.s601059

Institutions: Optimum Patient Care, Observational & Pragmatic Research Institute, Universidade do Porto, Institute of Public Health, University of Porto, King's College London, University of Alberta, Southern University of Science and Technology, ShenZhen People’s Hospital, University of Dundee, Ninewells Hospital, University of Hull, Hull York Medical School, University of Liverpool, Liverpool School of Tropical Medicine, Norfolk Community Health and Care NHS Trust, University of Leeds, Leeds Teaching Hospitals NHS Trust, Salford Royal NHS Foundation Trust, University of Manchester, Salford Royal Hospital, University of Exeter, Royal College of Physicians, University College London, AstraZeneca (United Kingdom), Weill Cornell Medical Center, Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Vall d'Hebron Institut de Recerca, Vall d'Hebron Hospital Universitari, Nara Medical University, AstraZeneca (Sweden), Imperial College London, Manchester University NHS Foundation Trust, Keele University, University of Freiburg, AstraZeneca (United States), NIHR Southampton Biomedical Research Centre, University of Southampton, University of Aberdeen

Language: English

Topic: Chronic Obstructive Pulmonary Disease (COPD) Research

Subfield: Pulmonary and Respiratory Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

Funders: Amgen, Eli Lilly and Company, AstraZeneca, GlaxoSmithKline, Sanofi, Teva Pharmaceutical Industries, CSL Behring, Regeneron Pharmaceuticals, Genentech, Sanofi Genzyme, Efficacy and Mechanism Evaluation Programme

OpenAlex ID: W7223005186