The PACE (Primary care use of a C-Reactive protein Point-of-care test to help target antibiotic prescribing to patients with acute exacerbations of Chronic Obstructive Pulmonary Disease (AECOPD) who are most likely to benefit) study is a research project currently underway at the Division of Population Medicine at Cardiff University. The aim is to determine whether the current standard management of a disease called Chronic Obstructive Pulmonary Disease (COPD) can be improved by introducing a simple finger-prick blood test to GP practices.
COPD is a lung condition, strongly associated with smoking, which leads to chronic narrowing of the airways leading to breathlessness and frequent acute attacks known as ‘exacerbations’. Exacerbations have various triggers, including infections, and during these periods patients with COPD become more unwell and frequently require antibiotics.
Patients with exacerbations are usually treated by their GP and are frequently given antibiotics. However not all exacerbations require antibiotics, and the use of antibiotics can have significant side effects and widespread use has led to many bacteria becoming resistant to antibiotics. The new blood test should hopefully provide an extra guide as to whether a patient would benefit from antibiotics or not, hopefully leading to a decrease in their prescription.
Patients enrolled in the trial will be advised to urgently see their GP. There, using a new point-of-care test, a finger-prick blood test will be taken to measure C-reactive protein (CRP), a marker for inflammation, in the blood. A high level of CRP could indicate the presence of a bacterial infection and hence the need for antibiotics. The level of CRP will be used in addition to a full assessment of the patient to decide whether they need antibiotics or not. Patients will then be followed up to see how their illness progresses.
This trial is currently in the recruitment phase at GP practices across Wales, and it is hoped that it will lead to better patient outcomes in the management of acute exacerbations of COPD.