Dionne E Smid1, Martijn A Spruit2, Sarah Houben-Wilke2, Jean W M Muris3, Gernot G U Rohde4, Emiel F M Wouters5, Frits M E Franssen5. 1. Department of Research & Education, CIRO, Hornerheide 1, 6085 NM, Horn, The Netherlands. Electronic address: dionnesmid@ciro-horn.nl. 2. Department of Research & Education, CIRO, Hornerheide 1, 6085 NM, Horn, The Netherlands. 3. Caphri School of Public Health and Primary Care, Department of Family Medicine, P.O. Box 616, 6200 MD, Maastricht University, Maastricht, The Netherlands. 4. Department of Respiratory Medicine, Maastricht University Medical Centre, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. 5. Department of Research & Education, CIRO, Hornerheide 1, 6085 NM, Horn, The Netherlands; Department of Respiratory Medicine, Maastricht University Medical Centre, P.O. Box 616, 6200 MD, Maastricht, The Netherlands.
Abstract
INTRODUCTION: Care for patients with chronic obstructive pulmonary disease (COPD) can be provided in primary, secondary or tertiary care. Whether and to what extent patients with COPD treated in various healthcare settings differ in disease burden and healthcare utilization remains unknown. Therefore, daily symptoms, functional mobility, mood status, health status and healthcare utilization were compared between COPD patients in various care settings, to explore possibilities for healthcare-optimization. METHODS: Current data are part of the Chance study. Demographics, functional mobility (Care Dependency Scale (CDS); Timed-Up-and-Go (TUG) test), mood status (Hospital Anxiety and Depression scale (HADS)), health status (COPD Assessment test (CAT); Clinical COPD questionnaire (CCQ); COPD specific St. George Respiratory questionnaire (SGRQ-C)), received treatments and severity of physical and psychological symptoms were assessed in subjects with and without COPD. RESULTS: 836 subjects (100 primary care patients, 100 secondary care patients, 518 tertiary care patients and 118 non-COPD subjects) were included. The burden of disease significantly increased from primary care to tertiary care. However, in all three healthcare settings a high percentage of patients with an impaired health status was observed (i.e. CAT ≥10 points, 68.0% vs. 91.0% vs. 94.5%, respectively). Furthermore, many patients treated in secondary care remain highly symptomatic despite treatment, while others with low burden of disease would allow for de-intensification of care. CONCLUSION: This study revealed important shortcomings and challenges for the care of COPD patients in the Netherlands. It emphasizes the need for detailed patient characterization and more individualized treatment, independent of the healthcare setting.
INTRODUCTION: Care for patients with chronic obstructive pulmonary disease (COPD) can be provided in primary, secondary or tertiary care. Whether and to what extent patients with COPD treated in various healthcare settings differ in disease burden and healthcare utilization remains unknown. Therefore, daily symptoms, functional mobility, mood status, health status and healthcare utilization were compared between COPDpatients in various care settings, to explore possibilities for healthcare-optimization. METHODS: Current data are part of the Chance study. Demographics, functional mobility (Care Dependency Scale (CDS); Timed-Up-and-Go (TUG) test), mood status (Hospital Anxiety and Depression scale (HADS)), health status (COPD Assessment test (CAT); Clinical COPD questionnaire (CCQ); COPD specific St. George Respiratory questionnaire (SGRQ-C)), received treatments and severity of physical and psychological symptoms were assessed in subjects with and without COPD. RESULTS: 836 subjects (100 primary care patients, 100 secondary care patients, 518 tertiary care patients and 118 non-COPD subjects) were included. The burden of disease significantly increased from primary care to tertiary care. However, in all three healthcare settings a high percentage of patients with an impaired health status was observed (i.e. CAT ≥10 points, 68.0% vs. 91.0% vs. 94.5%, respectively). Furthermore, many patients treated in secondary care remain highly symptomatic despite treatment, while others with low burden of disease would allow for de-intensification of care. CONCLUSION: This study revealed important shortcomings and challenges for the care of COPDpatients in the Netherlands. It emphasizes the need for detailed patient characterization and more individualized treatment, independent of the healthcare setting.
Authors: Frits M E Franssen; Dionne E Smid; Dorly J H Deeg; Martijn Huisman; Jan Poppelaars; Emiel F M Wouters; Martijn A Spruit Journal: NPJ Prim Care Respir Med Date: 2018-08-10 Impact factor: 2.871
Authors: Alex J van 't Hul; Eleonore H Koolen; Jeanine C Antons; Marianne de Man; Remco S Djamin; Johannes C C M In 't Veen; Sami O Simons; Michel van den Heuvel; Bram van den Borst; Martijn A Spruit Journal: ERJ Open Res Date: 2020-11-02
Authors: Sarah Houben-Wilke; Daisy J A Janssen; Frits M E Franssen; Lowie E G W Vanfleteren; Emiel F M Wouters; Martijn A Spruit Journal: Health Qual Life Outcomes Date: 2018-10-30 Impact factor: 3.186