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. 2017 Jan 6;12(1):e0167887.
doi: 10.1371/journal.pone.0167887. eCollection 2017.

Does an Integrated Care Intervention for COPD Patients Have Long-Term Effects on Quality of Life and Patient Activation? A Prospective, Open, Controlled Single-Center Intervention Study

Elena Titova  1   2 , Øyvind Salvesen  3 , Signe Berit Bentsen  4 , Synnøve Sunde  2 , Sigurd Steinshamn  1   2 , Anne Hildur Henriksen  1   2
Affiliations

Does an Integrated Care Intervention for COPD Patients Have Long-Term Effects on Quality of Life and Patient Activation? A Prospective, Open, Controlled Single-Center Intervention Study

Elena Titova et al. PLoS One. .

Abstract

Background: Implementation of the COPD-Home integrated disease management (IDM) intervention at discharge after hospitalizations for acute exacerbations of COPD (AECOPD) led to reduced hospital utilization during the following 24 months compared to the year prior to study start.

Aims: To analyze the impact of the COPD-Home IDM intervention on health related quality of life, symptoms of anxiety and depression, and the degree of patient activation during 24 months of follow-up and to assess the association between these outcomes.

Methods: A single center, prospective, open, controlled clinical study. Changes in The St. George Respiratory Questionnaire (SGRQ), the Hospital anxiety (HADS-A) and depression (HADS-D) and the patient activation measure (PAM) scores were compared between the patients in the integrated care group (ICG) and the usual care group (UCG) 6, 12 and 24 months after enrolment.

Results: The questionnaire response rate was 80-96%. There were no statistically significant differences in the change of the SGRQ scores between the groups during follow up. After 12 months of follow-up there was a trend towards a reduction in the mean HADS-A score in the ICG compared to the UCG. The HADS-D scores remained stable in the ICG compared with an increasing trend in the UCG. Clinically significant difference in the PAM score was achieved only in the ICG, 6.7 (CI95% 0.7 to 7.5) compared to 3.6 (CI95% -1.4 to 8.6) in the UCG. In a logistic regression model a higher HADS-D score and current smoking significantly increased the odds for a low PAM score.

Conclusion: The COPD-Home IDM intervention did not result in any statistically significant changes in mean SGRQ, HADS-A, HADS- D or PAM scores during the 24 months of follow-up.

Trial registration: The ID number for the study in the Clinical.Trials.gov registration system is 17417. ClinicalTrials.gov Identifier: NCT 00702078.

Trial registration: ClinicalTrials.gov NCT00702078.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Schematic presentation of participant and number of respondents in percent (%) to participants in the study during 24 months of follow-up.
IC: integrated care; UC: Usual care; SGRQ: the St.George’s Respiratory Questionnaire; HADS: the Hospital Anxiety and Depression Scale; PAM: the Patient Activation Measure.
See this image and copyright information in PMC

References

    1. Global Strategy for Diagnosis, Management, and Prevention of COPD Updated January 2015: Global Initiative for Chronic Obstructive Lung Disease; 2015 [cited 2016 March]. http://www.goldcopd.org/.
    1. Rice K, Bourbeau J, MacDonald R, Wilt TJ. Collaborative self-management and behavioral change. Clin Chest Med. 2014;35(2):337–51. Epub 2014/05/31. 10.1016/j.ccm.2014.02.004 - DOI - PubMed
    1. Nici L, ZuWallack R. An official American Thoracic Society workshop report: the Integrated Care of The COPD Patient. Proceedings of the American Thoracic Society. 2012;9(1):9–18. Epub 2012/03/17. 10.1513/pats.201201-014ST - DOI - PubMed
    1. Kruis AL, Smidt N, Assendelft WJ, Gussekloo J, Boland MR, Rutten-van Molken M, et al. Integrated disease management interventions for patients with chronic obstructive pulmonary disease. The Cochrane database of systematic reviews. 2013;10:CD009437. Epub 2013/10/11. - PubMed
    1. Hernandez C, Alonso A, Garcia-Aymerich J, Serra I, Marti D, Rodriguez-Roisin R, et al. Effectiveness of community-based integrated care in frail COPD patients: a randomised controlled trial. NPJ primary care respiratory medicine. 2015;25:15022 Epub 2015/04/10. 10.1038/npjpcrm.2015.22 - DOI - PMC - PubMed

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