TY - JOUR
T1 - Disease management program for chronic obstructive pulmonary disease a randomized controlled trial
AU - Rice, Kathryn L.
AU - Dewan, Naresh
AU - Bloomfield, Hanna E.
AU - Grill, Joseph
AU - Schult, Tamara M.
AU - Nelson, David B.
AU - Kumari, Sarita
AU - Thomas, Mel
AU - Geist, Lois J.
AU - Beaner, Caroline
AU - Caldwell, Michael
AU - Niewoehner, Dennis E.
PY - 2010/10/1
Y1 - 2010/10/1
N2 - Rationale: The effect of disease management for chronic obstructive pulmonary disease (COPD) is not well established. Objectives: To determine whether a simplified disease management program reduces hospital admissions and emergency department (ED) visits due to COPD. Methods: We performed a randomized, adjudicator-blinded, controlled, 1-year trial at five Veterans Affairs medical centers of 743 patients with severe COPD and one or more of the following during the previous year: hospital admission or ED visit for COPD, chronic home oxygen use, or course of systemic corticosteroids for COPD. Control group patients received usual care. Intervention group patients received a single 1- to 1.5-hour education session, an action plan for self-treatment of exacerbations,andmonthly follow-up calls from a case manager. Measurements and Main Results: We determined the combined number of COPD-related hospitalizations and ED visits per patient. Secondary outcomes included hospitalizations and ED visits for all causes, respiratory medication use, mortality, and change in Saint George's Respiratory Questionnaire. After 1 year, the mean cumulative frequency of COPD-related hospitalizations and ED visits was 0.82 per patient in usual care and 0.48 per patient in disease management (difference, 0.34; 95% confidence interval, 0.15-0.52; P < 0.001). Disease management reduced hospitalizations for cardiac or pulmonary conditions other than COPD by 49%, hospitalizations for all causes by 28%, and ED visits for all causes by 27% (P < 0.05 for all). Conclusions: A relatively simple disease management program reduced hospitalizations and ED visits for COPD. Clinical trial registered with www.clinicaltrials.gov (NCT00126776).
AB - Rationale: The effect of disease management for chronic obstructive pulmonary disease (COPD) is not well established. Objectives: To determine whether a simplified disease management program reduces hospital admissions and emergency department (ED) visits due to COPD. Methods: We performed a randomized, adjudicator-blinded, controlled, 1-year trial at five Veterans Affairs medical centers of 743 patients with severe COPD and one or more of the following during the previous year: hospital admission or ED visit for COPD, chronic home oxygen use, or course of systemic corticosteroids for COPD. Control group patients received usual care. Intervention group patients received a single 1- to 1.5-hour education session, an action plan for self-treatment of exacerbations,andmonthly follow-up calls from a case manager. Measurements and Main Results: We determined the combined number of COPD-related hospitalizations and ED visits per patient. Secondary outcomes included hospitalizations and ED visits for all causes, respiratory medication use, mortality, and change in Saint George's Respiratory Questionnaire. After 1 year, the mean cumulative frequency of COPD-related hospitalizations and ED visits was 0.82 per patient in usual care and 0.48 per patient in disease management (difference, 0.34; 95% confidence interval, 0.15-0.52; P < 0.001). Disease management reduced hospitalizations for cardiac or pulmonary conditions other than COPD by 49%, hospitalizations for all causes by 28%, and ED visits for all causes by 27% (P < 0.05 for all). Conclusions: A relatively simple disease management program reduced hospitalizations and ED visits for COPD. Clinical trial registered with www.clinicaltrials.gov (NCT00126776).
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U2 - 10.1164/rccm.200910-1579OC
DO - 10.1164/rccm.200910-1579OC
M3 - Article
C2 - 20075385
AN - SCOPUS:77958195327
VL - 182
SP - 890
EP - 896
JO - American Review of Respiratory Disease
JF - American Review of Respiratory Disease
SN - 1073-449X
IS - 7
ER -