OBJECTIVE: To evaluate a partnership model of care for patients with a diagnosis of chronic obstructive pulmonary disease (COPD). DESIGN, SETTING AND PARTICIPANTS: Cluster randomised controlled trial with blinded outcome assessment of 44 general practices in south-western Sydney comprising 451 people with a diagnosis of COPD, conducted between 2006 and 2009. INTERVENTION: Participants from intervention group practices were visited at their home by a registered nurse withspecific training in COPD care who worked with the general practitioner, the patient and other health professionals to develop and implement an individualised care plan based on best-practice guidelines. Participants from control group practices received usual care. MAIN OUTCOME MEASURES: The primary outcome was disease-related quality of life measured using the St George's Respiratory Questionnaire (SGRQ) at 12-month follow-up. Other outcomes were overall quality of life, lung function, smoking status, immunisation status, patient knowledge of COPD, and health service use. RESULTS: Of the 451 participants, 257 (57.8%) were confirmed as having COPD on post-bronchodilator spirometry. Follow-up was completed for 330 patients (73.2%). At 12 months, there was no statistically significant difference in the mean SGRQ scores between intervention and control groups (38.7 v 37.6; difference, 1.1; 95% CI, - 1.53-3.74; P = 0.41) or in measures of quality of life, lung function and smoking status. Compared with the control group, in the intervention group, attendance at pulmonary rehabilitation was more frequent (31.1% v 9.6%; OR, 5.16; 95% CI, 2.40-11.10; P = 0.002) and the mean COPD knowledge score was higher (10.5 v 9.8; difference, 0.70; CI, 0.10-1.21; P = 0.02). CONCLUSION: The nurse-GP partnership intervention did not have an impact on disease-related quality of life at 12-month follow-up. However, there was evidence of improved quality of care, in particular, in attendance at pulmonary rehabilitation and patient knowledge of COPD. TRIAL REGISTRATION: Australian Clinical Trials Registry ACTRN012606000304538.
RCT Entities:
OBJECTIVE: To evaluate a partnership model of care for patients with a diagnosis of chronic obstructive pulmonary disease (COPD). DESIGN, SETTING AND PARTICIPANTS: Cluster randomised controlled trial with blinded outcome assessment of 44 general practices in south-western Sydney comprising 451 people with a diagnosis of COPD, conducted between 2006 and 2009. INTERVENTION: Participants from intervention group practices were visited at their home by a registered nurse with specific training in COPD care who worked with the general practitioner, the patient and other health professionals to develop and implement an individualised care plan based on best-practice guidelines. Participants from control group practices received usual care. MAIN OUTCOME MEASURES: The primary outcome was disease-related quality of life measured using the St George's Respiratory Questionnaire (SGRQ) at 12-month follow-up. Other outcomes were overall quality of life, lung function, smoking status, immunisation status, patient knowledge of COPD, and health service use. RESULTS: Of the 451 participants, 257 (57.8%) were confirmed as having COPD on post-bronchodilator spirometry. Follow-up was completed for 330 patients (73.2%). At 12 months, there was no statistically significant difference in the mean SGRQ scores between intervention and control groups (38.7 v 37.6; difference, 1.1; 95% CI, - 1.53-3.74; P = 0.41) or in measures of quality of life, lung function and smoking status. Compared with the control group, in the intervention group, attendance at pulmonary rehabilitation was more frequent (31.1% v 9.6%; OR, 5.16; 95% CI, 2.40-11.10; P = 0.002) and the mean COPD knowledge score was higher (10.5 v 9.8; difference, 0.70; CI, 0.10-1.21; P = 0.02). CONCLUSION: The nurse-GP partnership intervention did not have an impact on disease-related quality of life at 12-month follow-up. However, there was evidence of improved quality of care, in particular, in attendance at pulmonary rehabilitation and patient knowledge of COPD. TRIAL REGISTRATION: Australian Clinical Trials Registry ACTRN012606000304538.
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: Ofra Kalter-Leibovici; Michal Benderly; Laurence S Freedman; Galit Kaufman; Tchiya Molcho Falkenberg Luft; Havi Murad; Liraz Olmer; Meri Gluch; David Segev; Avi Gilad; Said Elkrinawi; Tali Cukierman-Yaffe; Baruch Chen; Orit Jacobson; Calanit Key; Mordechai Shani; Gershon Fink Journal: Am J Respir Crit Care Med Date: 2018-06-15 Impact factor: 21.405
Authors: Jade Schrijver; Anke Lenferink; Marjolein Brusse-Keizer; Marlies Zwerink; Paul Dlpm van der Valk; Job van der Palen; Tanja W Effing Journal: Cochrane Database Syst Rev Date: 2022-01-10
Authors: Jenifer Liang; Michael J Abramson; Nicholas Zwar; Grant Russell; Anne E Holland; Billie Bonevski; Ajay Mahal; Benjamin van Hecke; Kirsten Phillips; Paula Eustace; Eldho Paul; Kate Petrie; Sally Wilson; Johnson George Journal: BMJ Open Date: 2017-09-18 Impact factor: 2.692
Authors: Nini H Jonkman; Heleen Westland; Jaap Ca Trappenburg; Rolf Hh Groenwold; Erik Wma Bischoff; Jean Bourbeau; Christine E Bucknall; David Coultas; Tanja W Effing; Michael J Epton; Frode Gallefoss; Judith Garcia-Aymerich; Suzanne M Lloyd; Evelyn M Monninkhof; Huong Q Nguyen; Job van der Palen; Kathryn L Rice; Maria Sedeno; Stephanie Jc Taylor; Thierry Troosters; Nicholas A Zwar; Arno W Hoes; Marieke J Schuurmans Journal: Int J Chron Obstruct Pulmon Dis Date: 2016-08-31