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| ID | Type | Description | Link |
|---|---|---|---|
| ZonMw grant: 945.04.230 | Other Grant/Funding Number | ZonMw | |
| Picasso grant: 005.2004 | Other Grant/Funding Number | Picasso | |
| CMO: 2004/249 | Other Identifier | Medical Ethics Committee |
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| Name | Class |
|---|---|
| ZonMw: The Netherlands Organisation for Health Research and Development | OTHER |
| PICASSO: Partners in Care Solutions for COPD | OTHER |
| Erasmus Medical Center | OTHER |
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In this randomized controlled trial, three contemporary modes for chronic obstructive pulmonary disease (COPD) management in Dutch general practices are compared for costs and effects:
All three interventions are based on existing guidelines, materials, and field experiences.
Considering the ageing of the Dutch population and the current and increasing shortage of general practitioners (GPs), the capacity of primary healthcare is a major and growing concern. Delegation of care normally provided by GPs with care provided by trained practice nurses is now rapidly emerging for patients with chronic respiratory disease, i.e. asthma and chronic obstructive pulmonary disease (COPD). However, most general practices still provide care at initiative of the patient self, because of the lack in scientific evidence and the costs of implementing a regular care structure. Self-care by patients may be an alternative to alleviate the growing load on primary health care.
The following two main research questions are addressed in this study.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| usual care | Active Comparator | usual care, i.e. COPD care at patient's own initiative, mostly for medical help during exacerbations |
|
| monitoring controls | Experimental | regular COPD care (monitoring) provided by practice nurse according to current COPD guidelines |
|
| self-management | Experimental | disease specific self-management program 'Living Well with COPD' |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| an integrated self-management education program | Behavioral | disease specific self-management program 'Living Well with COPD', developed in Montreal, Canada |
|
| Measure | Description | Time Frame |
|---|---|---|
| disease-specific health-related quality of life (HRQoL) | two years |
| Measure | Description | Time Frame |
|---|---|---|
| the number of exacerbations | two years | |
| generic quality of life | two years | |
| decline post- and pre-bronchodilator (BD) lung function indices |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Chris van Weel, FRCP | Department of General Practice, Radboud University, Nijmegen, The Netherlands | Study Chair |
| Tjard Schermer, PhD | Department of General Practice, Radboud University, Nijmegen, The Netherlands | Study Director |
| Erik Bischoff, MD | Department of General Practice, Radboud University, Nijmegen, The Netherlands | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Radboud University, Department of General Medicine | Nijmegen | 6500 HB | Netherlands |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 12622605 | Background | Bourbeau J, Julien M, Maltais F, Rouleau M, Beaupre A, Begin R, Renzi P, Nault D, Borycki E, Schwartzman K, Singh R, Collet JP; Chronic Obstructive Pulmonary Disease axis of the Respiratory Network Fonds de la Recherche en Sante du Quebec. Reduction of hospital utilization in patients with chronic obstructive pulmonary disease: a disease-specific self-management intervention. Arch Intern Med. 2003 Mar 10;163(5):585-91. doi: 10.1001/archinte.163.5.585. | |
| 12728158 |
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| McGill University |
| OTHER |
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| regular practice nurse review (monitoring controls) | Behavioral | protocol based on existing Guidelines: Dutch College of General Practitioners (NHG) Global Initiative for Chronic Obstructive Lung Disease (GOLD) |
|
| care at initiative of the patient (usual GP care) | Behavioral | care at initiative of the patient (usual GP care) |
|
| two years |
| level of respiratory symptoms | two years |
| satisfaction with the health care received | two years |
| compliance with (non-) pharmaceutical treatment | two years |
| direct and indirect medical costs | two years |
| COPD related self-efficacy | two years |
| COPD coping styles | two years |
| Background |
| Monninkhof E, van der Valk P, van der Palen J, van Herwaarden C, Partridge MR, Zielhuis G. Self-management education for patients with chronic obstructive pulmonary disease: a systematic review. Thorax. 2003 May;58(5):394-8. doi: 10.1136/thorax.58.5.394. |
| 14998597 | Background | Bourbeau J, Nault D, Dang-Tan T. Self-management and behaviour modification in COPD. Patient Educ Couns. 2004 Mar;52(3):271-7. doi: 10.1016/S0738-3991(03)00102-2. |
| 23190905 | Derived | Bischoff EW, Akkermans R, Bourbeau J, van Weel C, Vercoulen JH, Schermer TR. Comprehensive self management and routine monitoring in chronic obstructive pulmonary disease patients in general practice: randomised controlled trial. BMJ. 2012 Nov 28;345:e7642. doi: 10.1136/bmj.e7642. |
| ID | Term |
|---|---|
| D008173 | Lung Diseases, Obstructive |
| D029424 | Pulmonary Disease, Chronic Obstructive |
| ID | Term |
|---|---|
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D002908 | Chronic Disease |
| D020969 | Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
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