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Early intervention for chronic obstructive pulmonary disease by practice nurse and GP teams: a cluster randomized trial.
- Source :
- Family Practice; Dec2016, Vol. 33 Issue 6, p663-670, 8p, 2 Diagrams, 3 Charts
- Publication Year :
- 2016
-
Abstract
- <bold>Background: </bold>Early detection and intervention for chronic obstructive pulmonary disease (COPD) could potentially slow disease progress and minimize harm.<bold>Objectives: </bold>To assess the effectiveness of early intervention by a practice nurse-GP team on quality of life (QoL) and process of care in patients with newly diagnosed COPD, compared with usual care. Nurses and GPs in intervention practices were educated to develop and implement disease management plans for COPD.<bold>Methods: </bold>A 12-month, multicentre, pragmatic randomized controlled trial with blinded outcome assessment was conducted. Participants were current and former smokers aged 40 to 85 years newly identified as having COPD on post-bronchodilator spirometry. The primary outcome was health-related QoL, assessed with the St George's Respiratory Questionnaire (SGRQ). Secondary outcome measures were other QoL measures, lung function, disease knowledge, smoking and immunization status, inhaler technique and health service use.<bold>Results: </bold>Of the 10 234 patients from 36 practices in Sydney invited to a case-finding appointment, 1641 (16%) attended and 287 (18%) were diagnosed with COPD. Nineteen practices (144 patients) were randomized to the intervention group and 17 practices (110 patients) to the control group. Only 15.3% (n = 22) patients in the intervention group saw the nurse for COPD care following case finding. There was no between-group difference in SGRQ score at follow-up (mean difference -0.21; P = 0.86). Influenza vaccination was higher in the intervention group (OR 2.31: P = 0.035), but there were no other significant between-group differences in outcomes.<bold>Conclusion: </bold>Intervention uptake was low and had no additional beneficial effect, over usual care, on participants' health-related QoL. [ABSTRACT FROM AUTHOR]
- Subjects :
- OBSTRUCTIVE lung disease treatment
EARLY medical intervention
FAMILY medicine
NURSING
QUALITY of life
RANDOMIZED controlled trials
INFLUENZA prevention
OBSTRUCTIVE lung disease diagnosis
NURSING education
COMPARATIVE studies
HEALTH attitudes
HEALTH care teams
IMMUNIZATION
OBSTRUCTIVE lung diseases
RESEARCH methodology
MEDICAL cooperation
MEDICAL protocols
NURSES
CONTINUING education of nurses
PHYSICIANS
QUESTIONNAIRES
RESEARCH
RESPIRATORY measurements
SMOKING
CONTINUING medical education
OCCUPATIONAL roles
EVALUATION research
VITAL capacity (Respiration)
BLIND experiment
Subjects
Details
- Language :
- English
- ISSN :
- 02632136
- Volume :
- 33
- Issue :
- 6
- Database :
- Complementary Index
- Journal :
- Family Practice
- Publication Type :
- Academic Journal
- Accession number :
- 120308464
- Full Text :
- https://doi.org/10.1093/fampra/cmw077