Evaluation of a Nurse-Led Educational Telephone Intervention to Support Self-Management of Patients With Chronic Obstructive Pulmonary Disease: A Randomized Feasibility Study

Abstract

This randomized, two armed feasibility study in a UK General Practice Surgery investigated the feasibility of introducing a nurse-led educational telephone intervention for patients with chronic obstructive pulmonary disease (COPD) to reinforce their understanding and use of their self-management plan.

Methods: 73 patients were randomly allocated to a control group which received standard care including a self-management plan or an intervention group which received in addition, two scheduled telephone calls over six weeks from a practice nurse. Calls were tailored to the needs of the patient, but provided education about the use of their plan to manage exacerbations, use of health services and emergency medication. The primary endpoint to be tested was the impact of symptoms assessed by the COPD Assessment Tool (CAT) at baseline and 12 weeks. Secondary endpoints were self-reported exacerbations, emergency visits and service satisfaction.

Results: Follow-up CAT data was available for 69 of the 73 randomized patients. CAT scores in the intervention group decreased significantly showing improvement between time 1 and 2 (Time 1 = 15.56 vs 12.44 at Time 2, Mean difference: 3.12, CI 1.52 -4.72, p <0.05) with no significant change in the control group. A significant difference between the CAT scores of the intervention and control groups was found at time 2 adjusting for baseline CAT scores at time 1 (-2.38 (-4.40 to -0.36) p <0.05.) No significant change was found in exacerbations between the groups at time 2. Satisfaction ratings did not vary significantly between the intervention and control groups over time.

Conclusion: A nurse-led telephone intervention is feasible in primary care and may help to improve patients' health and well-being.

Keywords: COPD assessment tool questionnaire; action plans; primary care; symptom exacerbation; telephone support.