OBJECTIVES: To evaluate usefulness of limited community based care for patients with chronic obstructive pulmonary disease after discharge from hospital. DESIGN: Randomised controlled trial. SETTING: Liverpool Health Service and Macarthur Health Service in outer metropolitan Sydney between September 1999 and July 2000. PARTICIPANTS: 177 patients randomised into an intervention group (84 patients) and a control group (93 patients) which receivedcurrent usual care. INTERVENTIONS: Home visits by community nurse at one and four weeks after discharge and preventive general practitioner care. MAIN OUTCOME MEASURES: Frequency of patients' presentation and admission to hospital; changes in patients' disease-specific quality of life, measured with St George's respiratory questionnaire, over three months after discharge; patients' knowledge of illness, self management, and satisfaction with care at discharge and three months later; frequency of general practitioner and nurse visits and their satisfaction with care. RESULTS: Intervention and control groups showed no differences in presentation or admission to hospital or in overall functional status. However, the intervention group improved their activity scores and the control group worsened their symptom scores. While intervention group patients received more visits from community nurses and were more satisfied with their care, involvement of general practitioners was much less (with only 31% (22) remembering receiving a care plan). Patients in the intervention group had higher knowledge scores and were more satisfied. There were no differences in general practitioner visits or management. CONCLUSIONS: This brief intervention after acute care improved patients' knowledge and some aspects of quality of life. However, it failed to prevent presentation and readmission to hospital.
RCT Entities:
OBJECTIVES: To evaluate usefulness of limited community based care for patients with chronic obstructive pulmonary disease after discharge from hospital. DESIGN: Randomised controlled trial. SETTING: Liverpool Health Service and Macarthur Health Service in outer metropolitan Sydney between September 1999 and July 2000. PARTICIPANTS: 177 patients randomised into an intervention group (84 patients) and a control group (93 patients) which received current usual care. INTERVENTIONS: Home visits by community nurse at one and four weeks after discharge and preventive general practitioner care. MAIN OUTCOME MEASURES: Frequency of patients' presentation and admission to hospital; changes in patients' disease-specific quality of life, measured with St George's respiratory questionnaire, over three months after discharge; patients' knowledge of illness, self management, and satisfaction with care at discharge and three months later; frequency of general practitioner and nurse visits and their satisfaction with care. RESULTS: Intervention and control groups showed no differences in presentation or admission to hospital or in overall functional status. However, the intervention group improved their activity scores and the control group worsened their symptom scores. While intervention group patients received more visits from community nurses and were more satisfied with their care, involvement of general practitioners was much less (with only 31% (22) remembering receiving a care plan). Patients in the intervention group had higher knowledge scores and were more satisfied. There were no differences in general practitioner visits or management. CONCLUSIONS: This brief intervention after acute care improved patients' knowledge and some aspects of quality of life. However, it failed to prevent presentation and readmission to hospital.
Authors: B J Smith; S L Appleton; P W Bennett; G C Roberts; P Del Fante; R Adams; C M Trott; D P Allan; A M Southcott; R E Ruffin Journal: Aust N Z J Med Date: 1999-10
Authors: Anke Lenferink; Marjolein Brusse-Keizer; Paul Dlpm van der Valk; Peter A Frith; Marlies Zwerink; Evelyn M Monninkhof; Job van der Palen; Tanja W Effing Journal: Cochrane Database Syst Rev Date: 2017-08-04
Authors: Darcy D Marciniuk; Donna Goodridge; Paul Hernandez; Graeme Rocker; Meyer Balter; Pat Bailey; Gord Ford; Jean Bourbeau; Denis E O'Donnell; Francois Maltais; Richard A Mularski; Andrew J Cave; Irvin Mayers; Vicki Kennedy; Thomas K Oliver; Candice Brown Journal: Can Respir J Date: 2011 Mar-Apr Impact factor: 2.409
Authors: Esther Dajczman; Chantal Robitaille; Pierre Ernst; Andrew Michael Hirsch; Norman Wolkove; David Small; Judy Bianco; Hartley Stern; Mark Palayew Journal: Can Respir J Date: 2013 Sep-Oct Impact factor: 2.409