OBJECTIVE AND BACKGROUND: COPD is a progressive disorder characterized by periodic exacerbations. While comprehensive self-management programmes decrease health-care resource utilization, the essential components are unclear. We performed a study of written action plans in the management of COPD. METHODOLOGY: A randomized, controlled, prospective parallel-group study compared written action plans to usual practice. SUBJECTS: Recruited from general practices, received an educational intervention with or without an action plan, which usually emphasized prompt treatment with antibiotics and corticosteroids. Subjects were followed up 3-monthly for a year. RESULTS:One hundred and thirty-nine participants, mean FEV(1) 45 +/- 16% predicted, were recruited, 81% completing the study. Both groups had a decline in lung function and physical activity, but increase in quality of life over the study period. Exacerbations were common. The intervention group was significantly more likely to have treatment with antibiotics (chi(2) = 3.86; d.f. = 1; P = 0.05) or short course oral corticosteroids (chi(2) = 14.25; d.f. = 1; P < 0.001). No differences were found between the number of general practitioner consultations, attendances at emergency departments or hospitalizations. CONCLUSIONS: The use of a written action plan in COPD increased appropriate therapeutic interventions for exacerbations, but this effect was not associated with a decrease in the use of health-care resources.
RCT Entities:
OBJECTIVE AND BACKGROUND:COPD is a progressive disorder characterized by periodic exacerbations. While comprehensive self-management programmes decrease health-care resource utilization, the essential components are unclear. We performed a study of written action plans in the management of COPD. METHODOLOGY: A randomized, controlled, prospective parallel-group study compared written action plans to usual practice. SUBJECTS: Recruited from general practices, received an educational intervention with or without an action plan, which usually emphasized prompt treatment with antibiotics and corticosteroids. Subjects were followed up 3-monthly for a year. RESULTS: One hundred and thirty-nine participants, mean FEV(1) 45 +/- 16% predicted, were recruited, 81% completing the study. Both groups had a decline in lung function and physical activity, but increase in quality of life over the study period. Exacerbations were common. The intervention group was significantly more likely to have treatment with antibiotics (chi(2) = 3.86; d.f. = 1; P = 0.05) or short course oral corticosteroids (chi(2) = 14.25; d.f. = 1; P < 0.001). No differences were found between the number of general practitioner consultations, attendances at emergency departments or hospitalizations. CONCLUSIONS: The use of a written action plan in COPD increased appropriate therapeutic interventions for exacerbations, but this effect was not associated with a decrease in the use of health-care resources.
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: Gerard J Criner; Jean Bourbeau; Rebecca L Diekemper; Daniel R Ouellette; Donna Goodridge; Paul Hernandez; Kristen Curren; Meyer S Balter; Mohit Bhutani; Pat G Camp; Bartolome R Celli; Gail Dechman; Mark T Dransfield; Stanley B Fiel; Marilyn G Foreman; Nicola A Hanania; Belinda K Ireland; Nathaniel Marchetti; Darcy D Marciniuk; Richard A Mularski; Joseph Ornelas; Jeremy D Road; Michael K Stickland Journal: Chest Date: 2015-04 Impact factor: 9.410
Authors: Charlotte C Poot; Eline Meijer; Annemarije L Kruis; Nynke Smidt; Niels H Chavannes; Persijn J Honkoop Journal: Cochrane Database Syst Rev Date: 2021-09-08
Authors: Jaap C A Trappenburg; Lieselotte Koevoets; Gerdien H de Weert-van Oene; Evelyn M Monninkhof; Jean Bourbeau; Thierry Troosters; Theo J M Verheij; Jan-Willem J Lammers; Augustinus J P Schrijvers Journal: BMC Pulm Med Date: 2009-12-29 Impact factor: 3.317
Authors: Marlies Zwerink; Marjolein Brusse-Keizer; Paul D L P M van der Valk; Gerhard A Zielhuis; Evelyn M Monninkhof; Job van der Palen; Peter A Frith; Tanja Effing Journal: Cochrane Database Syst Rev Date: 2014-03-19
Authors: Juan Miguel Sánchez-Nieto; Rubén Andújar-Espinosa; Roberto Bernabeu-Mora; Chunshao Hu; Beatriz Gálvez-Martínez; Andrés Carrillo-Alcaraz; Carlos Federico Álvarez-Miranda; Olga Meca-Birlanga; Eva Abad-Corpa Journal: Int J Chron Obstruct Pulmon Dis Date: 2016-08-17