{
  "abstract": "Introduction In Ireland, the Sláintecare programme has identified chronic disease as a priority, aiming to transition asthma and chronic obstructive pulmonary disease (COPD) care from tertiary care to patient-centred primary care and community hubs. This includes community-based resources: GP-direct access spirometry, community diagnostic clinics (CDC’s) and community pulmonary rehabilitation (PR). We created a ‘one-stop’ CDC for patients with suspected or confirmed asthma or COPD, close to where they lived. Patients availed of spirometry, consultant, clinical nurse specialist (CNS) and physiotherapist review at the one visit.Methods A retrospective study of patients who attended the CDC was compiled from its inception in April 2023 to April 2025. The source of referral, spirometry, diagnosis, and investigations was analysed from their electronic health record.Results 668 new patients were seen at the CDC. 64% referrals were from GP’s directly to the CDC, avoiding hospital wait-lists. Suspected COPD was the most common clinical query from GPs. After CDC, 302 patients (45.2%) were diagnosed with asthma, 151 were diagnosed with COPD (22.6%) & 70 diagnosed with ACOS (10.5%). Of the 151 COPD patients, 146 had diagnostic spirometry, whereby 118 (80.8%) had GOLD 1/2 COPD and 28 patients (19.2%) had GOLD 3/4 COPD. 21 patients received an alternate respiratory diagnosis (17 bronchiectasis, 3 lung cancer, 1 IPF). The remaining patients received an alternative diagnosis (normal, sinusitis, GORD or obesity).89% of patients availed of CNS review, whilst 38.5% availed of physiotherapy services. 82 patients (12%) were referred to PR.420 (62.9%) patients had medication changes, of which 327 (77.9%) were escalated and 93 (22.1%) were de-escalated.Most patients were discharged medically after one visit, with respiratory CNS and physiotherapy follow-up arranged, where appropriate. 78 patients (11.7%) required further investigations including CT Thorax, full PFT’s, bronchoscopy etc.Conclusions The ‘one stop’ CDC is an effective patient-centred model, whereby patients avail of diagnosis, treatment and self-management plan at one community clinic visit. The ‘shift left’ model away from hospitals improves GP access to specialist respiratory care. GPs are considering COPD as a diagnosis for their dyspnoeic patients, highlighting the value of timely specialist respiratory care in community settings.",
  "authors": [
    {
      "affiliations": [
        "Department of Respiratory Medicine, Galway University Hospital, Galway, Ireland"
      ],
      "name": "CY Song"
    },
    {
      "affiliations": [
        "Respiratory Service, Galway City Integrated Care Hub, Galway, Ireland"
      ],
      "name": "N Byrne"
    },
    {
      "affiliations": [
        "Respiratory Service, Galway City Integrated Care Hub, Galway, Ireland"
      ],
      "name": "N Duignan"
    },
    {
      "affiliations": [
        "Respiratory Service, Galway City Integrated Care Hub, Galway, Ireland"
      ],
      "name": "E Hall"
    },
    {
      "affiliations": [
        "Respiratory Service, Galway City Integrated Care Hub, Galway, Ireland"
      ],
      "name": "O Healy"
    },
    {
      "affiliations": [
        "Respiratory Service, Galway City Integrated Care Hub, Galway, Ireland"
      ],
      "name": "R Kelly"
    },
    {
      "affiliations": [
        "Respiratory Service, Galway City Integrated Care Hub, Galway, Ireland"
      ],
      "name": "M McGoldrick"
    },
    {
      "affiliations": [
        "Respiratory Service, Galway City Integrated Care Hub, Galway, Ireland"
      ],
      "name": "F Moore"
    },
    {
      "affiliations": [
        "Respiratory Service, Galway City Integrated Care Hub, Galway, Ireland"
      ],
      "name": "P Needham"
    },
    {
      "affiliations": [
        "Respiratory Service, Galway City Integrated Care Hub, Galway, Ireland"
      ],
      "name": "E O’Regan"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Galway University Hospital, Galway, Ireland"
      ],
      "name": "C Sherlock"
    },
    {
      "affiliations": [
        "Department of Respiratory Medicine, Galway University Hospital, Galway, Ireland"
      ],
      "name": "SM Walsh"
    }
  ],
  "title": "M18 Shifting COPD and asthma care left: analysis of the ‘one stop’ community diagnostic clinic in the West of Ireland",
  "uid": "4b457b88-dc0d-5cf4-a34c-1e10a15401e6"
}