Journal article
Disease Management Program for Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial
American journal of respiratory and critical care medicine, Vol.182(7), pp.890-896
2010
DOI: 10.1164/rccm.200910-1579OC
PMID: 20075385
Abstract
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).
Details
- Title: Subtitle
- Disease Management Program for Chronic Obstructive Pulmonary Disease: A Randomized Controlled Trial
- Creators
- Kathryn L Rice - Pulmonary Section, Department of Medicine, VA Medical Center, Minneapolis, Minnesota, United StatesNaresh Dewan - Pulmonary Section, Department of Medicine, VA Medical Center, Omaha, Nebraska, United StatesMichael Caldwell - Pulmonary Section, Department of Medicine, VA Medical Center, Omaha, Nebraska, United StatesDennis E Niewoehner - Pulmonary Section, Department of Medicine, VA Medical Center, Minneapolis, Minnesota, United StatesHanna E Bloomfield - Pulmonary Section, Department of Medicine, VA Medical Center, Minneapolis, Minnesota, United StatesJoseph Grill - Center for Chronic Disease Outcomes Research, Department of Medicine, VA Medical Center, Minneapolis, Minnesota, United StatesTamara M Schult - Center for Chronic Disease Outcomes Research, Department of Medicine, VA Medical Center, Minneapolis, Minnesota, United StatesDavid B Nelson - Center for Chronic Disease Outcomes Research, Department of Medicine, VA Medical Center, Minneapolis, Minnesota, United StatesSarita Kumari - Pulmonary Section, Department of Medicine, Pittsburgh VA Healthcare System, Pittsburgh, Pennsylvania, United StatesMel Thomas - Department of Medicine, VA Medical Center, Sioux Falls, South Dakota, United StatesLois J Geist - Carver College of Medicine, University of Iowa, Iowa City, Iowa, United StatesCaroline Beaner - Pulmonary Section, Department of Medicine, VA Medical Center, Minneapolis, Minnesota, United States
- Resource Type
- Journal article
- Publication Details
- American journal of respiratory and critical care medicine, Vol.182(7), pp.890-896
- Publisher
- American Thoracic Society
- DOI
- 10.1164/rccm.200910-1579OC
- PMID
- 20075385
- ISSN
- 1073-449X
- eISSN
- 1535-4970
- Language
- English
- Date published
- 2010
- Academic Unit
- Pulmonary, Critical Care, and Occupational Medicine; Provost Office Administration; Internal Medicine
- Record Identifier
- 9984213447702771
Metrics
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