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Background:  The efficacy of the German disease management programs (DMP) asthma and chronic obstructive pulmonary disease (COPD) cannot be shown with the legally bound documentations. Studies with control groups are rare. Aim of this work was to investigate in a cross-sectional study whether the disease control differs in participants (DMP+) and non-participants (DMP - ) of the DMPs asthma and COPD., Methods:  The study was a prospective multicenter cross-sectional study. Primary endpoints were the Asthma Control Test™ (ACT) in the asthma part of the study and the COPD Assessment Test™ (CAT) for the COPD part., Results:  A total of 1038 asthma patients and 846 COPD patients were included, of whom about 70 % participated in the corresponding DMP. The ACT total score was higher in asthma DMP+ patients than in DMP- patients (mean difference 0.86; 95 % CI: 0.29 - 1.43;p = 0.003), but not clinically relevant. For COPD there was no clinically relevant difference in COPD disease impact (0.52; 95 % CI: - 0.71 - 1.75; p = 0.405). Although DMP patients had to be enrolled in the respective DMP for at least one year, only 60 % of these patients had participated in a structured education. We did not observe a difference in disease control in DMP patients who respectively participated and did not participate in a structured education., Discussion:  There was no clinically relevant difference in disease control between DMP+ and DMP- patients. The efficacy of DMPs has been demonstrated internationally in randomized controlled trials. Randomized controlled trials should be conducted in Germany for demonstrating efficacy of DMPs asthma and COPD., Registration:  drks.de, DRKS00007664, Registration date: Jan 15, 2015., Competing Interests: Diese Studie wurde durch die Mundipharma GmbH finanziert. P. O. und B. L-B. sind Mitarbeiterinnen der Mundipharma GmbH. F. K. und A. Z. haben Beraterverträge mit der Mundipharma GmbH. A. Z. ist Mitglied der Schriftleitung der Dtsch Med Wochenschr., (© Georg Thieme Verlag KG Stuttgart · New York.)

Background: The efficacy of the German disease management programs (DMP) asthma and chronic obstructive pulmonary disease (COPD) cannot be shown with the legally bound documentations. Studies with control groups are rare. Aim of this work was to investigate in a cross-sectional study whether the disease control differs in participants (DMP+) and non-participants (DMP-) of the DMPs asthma and COPD., Methods: The study was a prospective multicenter cross-sectional study. Primary endpoints were the Asthma Control Test™ (ACT) in the asthma part of the study and the COPD Assessment Test™ (CAT) for the COPD part., Results: A total of 1038 asthma patients and 846 COPD patients were included, of whom about 70 % participated in the corresponding DMP. The ACT total score was higher in asthma DMP+ patients than in DMP- patients (mean difference 0.86; 95 %CI:0.29 - 1.43;p = 0.003), but not clinically relevant. For COPD there was no clinically relevant difference in COPD disease impact (0.52; 95 %CI:-0.71 - 1.75;p = 0.405). Although DMP patients had to be enrolled in the respective DMP for at least one year, only 60 % of these patients had participated in a structured education. We did not observe a difference in disease control in DMP patients who respectively participated and did not participate in a structured education., Discussion: There was no clinically relevant difference in disease control between DMP+ and DMP- patients. The efficacy of DMPs has been demonstrated internationally in randomized controlled trials. Randomized controlled trials should be conducted in Germany for demonstrating efficacy of DMPs asthma and COPD., Registration: drks.de, DRKS00007664, Registration date: Jan 15, 2015., Competing Interests: Diese Studie wurde durch die Mundipharma GmbH finanziert. P. O. und B.L-B. sind Mitarbeiterinnen der Mundipharma GmbH. F.K. und A.Z. haben Beraterverträge mit der Mundipharma GmbH. A.Z. ist Mitglied der Schriftleitung der Dtsch Med Wochenschr., (© Georg Thieme Verlag KG Stuttgart · New York.)

Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible, mostly progressive and associated with an abnormal inflammatory reaction. The course of this pulmonary disease is influenced by systemic inflammation and comorbidities. COPD is caused by inhaled gases and particles and therefore avoidance of inhalative smoking results in symptomatic relief and improvement of the course of the disease. Modulation of the characteristic pulmonary inflammation, which is present in airways, parenchyma and pulmonary vasculature is targeted by a variety of novel pharmacological approaches. Systemic inflammation associating COPD should also be influenced to improve the disease. Assessment of the benefits of these approaches is difficult since FEV (1.0) as the most popular marker to describe the functional severity of COPD does not always reflect the benefits of the novel therapeutic strategies. Therefore new therapeutic modalities must be paralleled by the development of new clinical relevant targets.

Chronic obstructive pulmonary disease (COPD) is characterized by airflow limitation that is not fully reversible. It is caused by chronic inflammation of the airways and the lung parenchyma. Symptomatic treatment is based on bronchodilatation, which leads to a reduction of hyperinflation and relief of dyspnea. Smoking cessation is the only known causative treatment option. Inhaled corticosteroids (ICS) reduce exacerbations and, potentially, mortality. Future therapies should ameliorate chronic inflammation and thus stop the annual decline of lung function. In face of increasing mortality and morbidity more research is needed.