Back to Search
Start Over
Early intervention for chronic obstructive pulmonary disease by practice nurse and GP teams : A cluster randomized trial
- Source :
- Family Practice, 33(6), 663-670. Oxford University Press
- Publication Year :
- 2016
- Publisher :
- Oxford University Press, 2016.
-
Abstract
- Background: Early detection and intervention for chronic obstructive pulmonary disease (COPD) could potentially slow disease progress and minimize harm.Objectives: 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. Methods: 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. Results: 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. Conclusion: Intervention uptake was low and had no additional beneficial effect, over usual care, on participants' health-related QoL. Refereed/Peer-reviewed
- Subjects :
- Male
Health Knowledge, Attitudes, Practice
medicine.medical_specialty
General Practice
Vital Capacity
smoking/tobacco use
Pulmonary disease
Primary care
Nurse's Role
Practice nurse
Patient Care Planning
Chronic disease
Pulmonary Disease, Chronic Obstructive
03 medical and health sciences
primary care
Education, Nursing, Continuing
0302 clinical medicine
nursing
quality of care
Forced Expiratory Volume
Intervention (counseling)
Influenza, Human
medicine
Humans
Single-Blind Method
030212 general & internal medicine
Cluster randomised controlled trial
Quality of care
Physician's Role
Aged
Patient Care Team
business.industry
respiratory diseases
Smoking
Vaccination
Middle Aged
030228 respiratory system
Family medicine
Quality of Life
Physical therapy
Case finding
Education, Medical, Continuing
Female
Nursing Staff
Family Practice
business
chronic disease
Subjects
Details
- Language :
- English
- ISSN :
- 02632136
- Database :
- OpenAIRE
- Journal :
- Family Practice, 33(6), 663-670. Oxford University Press
- Accession number :
- edsair.doi.dedup.....7e80f5a3b6c0f531649925d1992c3a85