Nicholas A Zwar1, Jeremy M Bunker2, Helen K Reddel3, Sarah M Dennis4,5, Sandy Middleton6, Onno C P van Schayck7, Alan J Crockett8, Iqbal Hasan5, Oshana Hermiz5, Sanjyot Vagholkar2, Wei Xuan9, Guy B Marks3,10. 1. School of Public Health and Community Medicine, UNSW Australia, UNSW Sydney, Australia, n.zwar@unsw.edu.au. 2. School of Public Health and Community Medicine, UNSW Australia, UNSW Sydney, Australia. 3. Woolcock Institute of Medical Research, University of Sydney, Glebe, Australia. 4. Faculty of Health Sciences, University of Sydney, Lidcombe, Australia. 5. Centre for Primary Health Care and Equity, UNSW Australia, UNSW Sydney, Australia. 6. Nursing Research Institute, St Vincent's Health Australia (Sydney) and Australian Catholic University, Darlinghurst, Australia. 7. Research School Caphri, Maastricht University, Maastricht, The Netherlands. 8. School of Health Sciences, University of South Australia, Adelaide, Australia. 9. Ingham Institute for Applied Medical Research, Liverpool, Australia and. 10. South Western Sydney Clinical School, UNSW Australia, Liverpool, Australia.
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.
RCT Entities:
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.
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: 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: 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