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Table 4 Multilevel logistic regression models of the variability in adherence to good clinical practice criteria for three categories: clinical evaluation of the patient, disease evaluation and therapeutic interventions

From: Variability in adherence to clinical practice guidelines and recommendations in COPD outpatients: a multi-level, cross-sectional analysis of the EPOCONSUL study

  Intra-class correlation (ICC) Median Odds Ratio (MOR) Variables Adjusted OR (95% CI) p
Adherence to good clinical practice criteria in clinical evaluation (≥3 criteria fulfilled)
 Empty model 1 0.36670 3.73040    
 Model 2: center variables1 0.31866 3.26487    
 Model 3: patient variables2 0.36831 3.74755    
 Full model 4 (center and patient) 0.31850 3.26345 Large hospital 0.40 (0.21–0.79) 0.008
Outpatient respiratory nursing clinic available 2.47 (1.26–4.83) 0.008
Active smokers 1.32 (1.10–1.58) 0.003
Charlson index ≥3 1.35 (1.15–1.59) < 0.001
Number of hospital admissions in the last year ≥1 6.33 (5.02–7.98) < 0.001
GesEPOC phenotype
 Not exacerbator (reference)   
 Exacerbator 0.79 (0.61–1.101) 0.063
 Missing 0.36 (0.29–0.44) < 0.001
To be taken care in specialized COPD outpatient clinic) 2.10 (1.56–2.72) < 0.001
1: included variables in the final center model: large hospital and outpatient respiratory nursing clinic available
2: included variables in the final patient model: active smokers, Charlson index ≥3, number of hospital admissions in the last year ≥1, to be taken care in specialized COPD outpatient clinic and GesEPOC phenotype exacerbator.
Adherence to good clinical practice criteria in COPD evaluation (≥4 criteria fulfilling)
 Empty model 1 0.30343 3.13266    
 Model 2: center variables1 0.26684 2.83994    
 Model 3: patient variables2 0.29100 3.02953    
 Full model 4 (center and patient) 0.24413 2.67316 Respiratory ward not available (reference)   
Respiratory ward < 20 beds 7.09 (2.53–9.90) < 0.001
Respiratory ward ≥20 beds 3.00 (1.37–6.60) 0.006
Age ≤ 55 1.58 (1.19–2.09) 0.001
Sex (male) 0.77 (0.61–0.96) 0.022
Charlson index ≥3 0.80 (0.68–0.94) 0.008
FEV1 <  50% 1.68 (1.42–1.99) < 0.001
Dyspnea (MRC-m)
 0–1 (reference)   
  ≥ 2 1.39 (1.13–1.72) 0.002
 Missing 0.69 (0.51–0.93) 0.017
 Level of dyspnea not referred to 0.65 (0.49–0.86) 0.003
GesEPOC phenotype
 Non-exacerbator (reference)   
 Exacerbator 1.16 (0.93–1.44) 0.185
 Missing 0.17 (0.14–0.21) < 0.001
Treatment at a specialized COPD outpatient clinic 3.25 (2.49–4.23) < 0.001
1: variables included in the final center model: in-patient respiratory clinic ≥20 present and specialized COPD outpatient clinic available.
2: variables included in the final patient model: age ≤ 55, gender (male), Charlson index ≥3, FEV1 <  50%, dyspnea, GesEPOC exacerbator phenotype and being treated in specialized COPD outpatient clinic.
Adherence to good clinical practice criteria in therapeutic intervention (≥3 criteria fulfilled)
 Empty model 1 0.52169 6.09155    
 Model 2: center variables1 0.46935 5.08927    
 Model 3: patient variables2 0.49994 5.64024    
 Full model 4 (center and patient) 0.44731 4.74211 University hospital 0.26 (0.08–0.85) 0.026
Outpatient respiratory nursing clinic availability 3.69 (1.50–9.11) 0.005
Age ≤ 55 0.60 (0.42–0.86) < 0.005
Sex (male) 0.72 (0.55–0.93) 0.014
Charlson index ≥3 1.19 (0.99–1.42) 0.062
Number of hospital admissions in the last year ≥1 1.71 (1.38–2.11) < 0.001
GesEPOC phenotype
 Non-exacerbator (reference)   
 Exacerbator 0.90 (0.71–1.15) 0.404
 Missing 0.36 (0.29–0.46) < 0.001
Treatment at a specialized COPD outpatient clinic 2.61 (2.01–3.40) <0.001
1: variables included in the final center model: university hospital and outpatient respiratory nursing clinic availability
2: variables included in the final patient model: age ≤ 55, gender (male), Charlson index ≥3, number of hospital admissions in the last year ≥1, GesEPOC exacerbator phenotype and being treated in specialized COPD outpatient clinic