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Peer-reviewedCC BY-NCPragmatic and observational research

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

  • Elango Vijaykumar1
  • James Gatenby2
  • Alexander Evans3
  • William Henley3
  • Neva Eleangovan2
  • Amy Couper3,4
  • Margee Kerr3,4
  • Cono Ariti2
  • John Busby3
  • Luis Alves5,6
  • Mona Bafadhel7
  • Mohit Bhutani8
29 more authors
  • Victoria Carter2
  • Rongchang Chen9
  • James Chalmers10
  • Michael G Crooks11,12
  • Graham Devereux13
  • Andrew P Dickens2
  • Daryl Freeman14
  • Chris P Gale15,16,17
  • John Martin Gibson18,19,20
  • David Halpin21
  • Katherine Hickman22,23
  • John R Hurst24
  • Jonathan Marshall25
  • Fernando J Martinez26
  • Marc Miravitlles27
  • Hana Mullerova28
  • Tamsin Morris29
  • Shigeo Muro30
  • Jonatan Natman31
  • Jennifer K Quint32
  • Anita Sharma33
  • Dave Singh34
  • Mukesh Singh35,36
  • Daiana Stolz37
  • Rachel Pullen3
  • Della Varghese38
  • Tom M Wilkinson39,40
  • Tonya Winders
  • David Price3,4
40 affiliations
  1. 1Modality Partnership, Horley, Surrey, UK.
  2. 2Optimum Patient Care, Cambridge, UK.
  3. 3Observational and Pragmatic Research Institute, Singapore, Singapore.
  4. 4Optimum Patient Care Global, Cambridge, UK.
  5. 5EPI Unit, Institute of Public Health, University of Porto, Porto, Portugal.
  6. 6Laboratory for Integrative and Translational Research in Population Health (ITR), Porto, Portugal.
  7. 7King's Centre for Lung Health, School of Immunology and Microbial Science, Faculty of Life Sciences and Medicine, King's College London, London, UK.
  8. 8Division of Pulmonary Medicine, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada.
  9. 9Key Laboratory of Respiratory Disease of Shenzhen, Shenzhen Institute of Respiratory Disease, Shenzhen People's Hospital (Second Affiliated Hospital of Jinan University, First Affiliated Hospital of South University of Science and Technology of China), Shenzhen, Guangdong, People's Republic of China.
  10. 10Scottish Centre for Respiratory Research, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK.
  11. 11Hull University Teaching Hospitals NHS Trust, Hull, UK.
  12. 12Hull York Medical School, University of Hull, Hull, UK.
  13. 13Clinical Sciences, Liverpool School of Tropical Medicine, University of Liverpool, Liverpool, UK.
  14. 14East of England Community Health & Care NHS Trust, Norwich, UK.
  15. 15Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
  16. 16Leeds Institute for Data Analytics, University of Leeds, Leeds, UK.
  17. 17Department of Cardiology, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
  18. 18NorthWest EHealth, Salford, UK.
  19. 19Department of Diabetes and Endocrinology, Salford Royal Hospital, Salford, UK.
  20. 20Division of Diabetes, Endocrinology and Gastroenterology, University of Manchester, Manchester, UK.
  21. 21University of Exeter Medical School, College of Medicine and Health, University of Exeter, Exeter, UK.
  22. 22NRAP, Care Quality Improvement Department (CQID), RCP, London, UK.
  23. 23Low Moor Medical Practice, Bradford, UK.
  24. 24UCL Respiratory, University College London, London, UK.
  25. 25Global Medical Affairs, BioPharmaceuticals Medical, AstraZeneca, Cambridge, UK.
  26. 26New York-Presbyterian Weill Cornell Medical Center, New York, NY, USA.
  27. 27Pneumology Dept, Hospital Universitari Vall d'Hebron, Vall d'Hebron Institut de Recerca (VHIR), Vall d'Hebron Barcelona Hospital Campus, CIBER de Enfermedades Respiratorias (CIBERES), Barcelona, Spain.
  28. 28Respiratory & Immunology, Medical and Payer Evidence Strategy, BioPharmaceuticals Medical, AstraZeneca, Cambridge, UK.
  29. 29Medical and Scientific Affairs, AstraZeneca, London, UK.
  30. 30Department of Respiratory Medicine, Nara Medical University, Nara, Japan.
  31. 31Evidence Statistics, BioPharmaceuticals Medical, AstraZeneca, Gothenburg, Sweden.
  32. 32School of Public Health, Imperial College London, London, UK.
  33. 33Platinum Medical Centre, Chermside, QLD, Australia.
  34. 34Division of Infection, Immunity & Respiratory Medicine, University of Manchester, Manchester University NHS Foundation Trust, Manchester, UK.
  35. 35Horse Fair Practice Group, Keele University Medical School Teaching Practice, Rugeley, UK.
  36. 36Staffordshire & Stoke-on-Trent ICB, Stafford, UK.
  37. 37Clinic of Respiratory Medicine and Faculty of Medicine, University of Freiburg, Freiburg, Germany.
  38. 38Evidence Strategy, BioPharmaceuticals Medical, AstraZeneca, Gaithersburg, MD, USA.
  39. 39NIHR Southampton BRC Southampton, Southampton, UK.
  40. 40Faculty of Medicine, University of Southampton, Southampton, UK.
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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.

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Cite

BibTeXRIS
BibTeX
@article{vijaykumar2026conquestadvance,
  title = {{CONQUEST-ADVANCE: Achieving proDuctiVe implementAtioN of CONQUEST Quality Standards in COPD Care.}},
  author = {Elango Vijaykumar and James Gatenby and Alexander Evans and William Henley and Neva Eleangovan and Amy Couper and Margee Kerr and Cono Ariti and John Busby and Luis Alves and Mona Bafadhel and Mohit Bhutani and Victoria Carter and Rongchang Chen and James Chalmers and Michael G Crooks and Graham Devereux and Andrew P Dickens and Daryl Freeman and Chris P Gale and John Martin Gibson and David Halpin and Katherine Hickman and John R Hurst and Jonathan Marshall and Fernando J Martinez and Marc Miravitlles and Hana Mullerova and Tamsin Morris and Shigeo Muro and Jonatan Natman and Jennifer K Quint and Anita Sharma and Dave Singh and Mukesh Singh and Daiana Stolz and Rachel Pullen and Della Varghese and Tom M Wilkinson and Tonya Winders and David Price},
  journal = {Pragmatic and observational research},
  year = {2026},
  month = oct,
  doi = {10.2147/por.s601059},
  url = {https://europepmc.org/article/MED/42928880},
  note = {CC BY-NC},
}
RIS
TY  - JOUR
TI  - CONQUEST-ADVANCE: Achieving proDuctiVe implementAtioN of CONQUEST Quality Standards in COPD Care.
AU  - Elango Vijaykumar
AU  - James Gatenby
AU  - Alexander Evans
AU  - William Henley
AU  - Neva Eleangovan
AU  - Amy Couper
AU  - Margee Kerr
AU  - Cono Ariti
AU  - John Busby
AU  - Luis Alves
AU  - Mona Bafadhel
AU  - Mohit Bhutani
AU  - Victoria Carter
AU  - Rongchang Chen
AU  - James Chalmers
AU  - Michael G Crooks
AU  - Graham Devereux
AU  - Andrew P Dickens
AU  - Daryl Freeman
AU  - Chris P Gale
AU  - John Martin Gibson
AU  - David Halpin
AU  - Katherine Hickman
AU  - John R Hurst
AU  - Jonathan Marshall
AU  - Fernando J Martinez
AU  - Marc Miravitlles
AU  - Hana Mullerova
AU  - Tamsin Morris
AU  - Shigeo Muro
AU  - Jonatan Natman
AU  - Jennifer K Quint
AU  - Anita Sharma
AU  - Dave Singh
AU  - Mukesh Singh
AU  - Daiana Stolz
AU  - Rachel Pullen
AU  - Della Varghese
AU  - Tom M Wilkinson
AU  - Tonya Winders
AU  - David Price
PY  - 2026
DA  - 2026/10/21
JO  - Pragmatic and observational research
DO  - 10.2147/por.s601059
UR  - https://europepmc.org/article/MED/42928880
AB  - 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.
SN  - 1179-7266
ER  -