Project Summary

PCORI has identified the need for large studies that look at real-life questions facing diverse patients, caregivers, and clinicians. In 2014, PCORI launched the Pragmatic Clinical Studies initiative to support large-scale comparative effectiveness studies focusing on everyday care for a wide range of patients. The Pragmatic Clinical Studies initiative funded this research project and others.

This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.

What is the research about?

People with chronic obstructive pulmonary disease, or COPD, have a hard time breathing and cough often. Symptoms can get worse quickly during episodes, known as flare-ups, and can result in a hospital stay or death. Treatments for COPD focus on reducing symptoms. Primary care providers, or PCPs, typically treat patients with COPD. But PCPs don’t always know what treatments are recommended for COPD.

Pulmonologists are doctors who treat patients with lung diseases. They are experts in the medicines used for treating COPD. They can support PCPs by sharing suggestions for treatment through the patient’s electronic health record, or EHR. Research has found that this approach improves patients’ quality of life. But the United States has few pulmonologists.

Pharmacists are also experts in the medicines used for treating COPD. In this study, the research team is looking to see if pharmacists can support PCPs in treating patients with COPD as well as pulmonologists.

Who can this research help?

Results may help health systems and clinics when considering ways to improve care for patients with COPD.

What is the research team doing?

The research team is enrolling at least 200 PCPs who treat patients with COPD. The PCPs are from US Department of Veterans Affairs, or VA, clinics in Washington State, Oregon, Minnesota, and South Carolina. The team is assigning PCPs by chance to receive treatment suggestions from pulmonologists or pharmacists.

The research team is using EHRs to identify patients with COPD who had a recent flare-up or received treatment that doesn’t follow COPD standards. Pulmonologists and pharmacists are reviewing EHRs for up to 4,000 patients who are receiving care from the PCPs. After these reviews, pulmonologists and pharmacists are sending treatment suggestions to PCPs through patients’ EHRs. The PCPs can accept, change, or reject the suggestions for treatment.

The research team is looking at EHRs after six months to see if patients experience a COPD flare-up, an illness, a hospital stay, or death. The team is also looking at how many suggested treatments the PCPs accept, and which treatments patients receive. Patients are completing a survey on their quality of life and the cost of their care.

Patients with COPD, the COPD Foundation, and the VA are helping to plan and conduct this study.

Research methods at a glance

Design ElementDescription
Study DesignRandomized controlled trial
Population200 PCPs of patients with COPD
  • Pharmacist-led management of COPD
  • Pulmonologist-led management of COPD

Primary: composite measure of COPD exacerbation, pneumonia, hospitalization, or death

Secondary: incidence of COPD flare-ups, incidence of pneumonia, number of hospital stays, incidence of death, the proportion of suggested therapies patients receive, COPD-related quality of life, PCP acceptance of suggestions from pharmacists and pulmonologists, patient-reported cost burden

Timeframe  Timeframe Length of follow-up for collecting data on primary outcomes. View Glossary 6-month follow-up for primary outcome

*Patient-Centered Economic Outcomes Funding Supplement
This study received supplemental funding to build on existing PCORI-funded comparative clinical effectiveness research (CER) studies to improve the understanding of appropriate costs and other economic burdens that are meaningful and inclusive to patients, caregivers and other stakeholders.

Project Information

David Au, MD, MS
Lucas Donovan, MD, MS
VA Puget Sound Health Care System
Pragmatic Trial to Enhance Quality Safety, and Patient Experience in COPD -- EQuiP COPD

Key Dates

March 2022
November 2028

Study Registration Information


Award Type
Health Conditions Health Conditions These are the broad terms we use to categorize our funded research studies; specific diseases or conditions are included within the appropriate larger category. Note: not all of our funded projects focus on a single disease or condition; some touch on multiple diseases or conditions, research methods, or broader health system interventions. Such projects won’t be listed by a primary disease/condition and so won’t appear if you use this filter tool to find them. View Glossary
Populations Populations PCORI is interested in research that seeks to better understand how different clinical and health system options work for different people. These populations are frequently studied in our portfolio or identified as being of interest by our stakeholders. View Glossary
Intervention Strategy Intervention Strategies PCORI funds comparative clinical effectiveness research (CER) studies that compare two or more options or approaches to health care, or that compare different ways of delivering or receiving care. View Glossary
State State The state where the project originates, or where the primary institution or organization is located. View Glossary
Last updated: April 5, 2024