Effect of health professional education on outcomes of chronic obstructive pulmonary disease in primary care: A non randomized clinical trial

Mònica Monteagudo, Teresa Rodriguez-Blanco, Maria Llagostera, Carles Valero, Xavier Bayona, Sílvia Granollers, Juan J. Ferro, Mateo Acedo, Jesús Almeda, Lluisa Rodriguez-Latre, Laura Muñoz, Marc Miravitlles

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    Abstract

    Background and objective The best strategy to achieve optimal integrated management to patients with chronic obstructive pulmonary disease (COPD) in primary care (PC) is not clear. We aimed to evaluate the effectiveness of an intervention in PC based on an integrated programme, which combines diverse strategies directed at health professionals to improve quality of life and clinical outcomes of their patients with COPD. We compared the outcome with results from standard practice. Methods A prospective, multicentre, quasi-experimental study and a 12-month follow up was performed. Intervention consisted of an integrated education programme in PC. The main outcome variable was the change in total score of the St. George's Respiratory Questionnaire (SGRQ) at the end of follow up between the control and intervention group. Results A total of 801 patients participated in the study with a mean age of 70.2 years and a mean FEV 1 (% predicted) of 55%. At 1-year follow up, the SGRQ score did not significantly differ. Although the intervention group showed an improvement in dietary, exercise and smoking habits, there was an increase in reported exacerbations and hospital admissions (P < 0.001). Conclusions Implementation of an integrated education programme in a PC setting, which combines diverse strategies directed at health professionals, did not achieve the expected changes in quality of life measured by SGRQ at 1-year follow up. Nonetheless, this study observed an improvement in patients' lifestyle choices, even though this did not result in a significant change in the clinical evolution or heath status over 12 months. © 2013 Asian Pacific Society of Respirology.
    Original languageEnglish
    Pages (from-to)718-727
    JournalRespirology
    Volume18
    Issue number4
    DOIs
    Publication statusPublished - 6 May 2013

    Keywords

    • chronic obstructive pulmonary disease
    • education
    • integrated programme
    • primary care

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