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| Name | Class |
|---|---|
| Pfizer | INDUSTRY |
| GlaxoSmithKline | INDUSTRY |
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The overall objective of this study is to evaluate a collaborative self-management intervention in patients with moderate to severe COPD in a primary care population. To achieve this objective the investigators developed a diagnostic and treatment pathway for the management of COPD in primary care that is based on national guidelines and focused on patient self-management.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Case Management and Self-Management Education | Experimental | A Certified Respiratory Educator (CRE) will obtain a detailed COPD history, provide general and self-management education, and confirm a management plan with the primary care physician. Specific elements of evidence-based management are targetted for intervention. Subjects will return for a follow-up visit in-person with the interdisciplinary care team including a CRE to review their health status including COPD symptoms, exacerbation diary, symptoms, MRC scale, etc as a minimum at 3 and 12 months. Telephone follow up will occur at a minimum at 6 and 9 months. |
|
| Usual Care | Placebo Comparator | A Certified Respiratory Educator (CRE) will meet with subjects to obtain a detailed COPD history and do a breathing test. Subjects will receive COPD care as usually provided by their physician. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Case Management and Self-Management Education | Other | A Certified Respiratory Educator (CRE) will obtain a detailed COPD history, provide general and self-management education, and confirm a management plan with the primary care physician. Specific elements of evidence-based management are targetted for intervention. Subjects will return for a follow-up visit in-person with the interdisciplinary care team including a CRE to review their health status including COPD symptoms, exacerbation diary, symptoms, MRC scale, etc as a minimum at 3 and 12 months. Telephone follow up will occur at a minimum at 6 and 9 months. |
| Measure | Description | Time Frame |
|---|---|---|
| COPD Assessment Test (CAT) | COPD related quality of life measure in primary care. | 1 Year |
| Measure | Description | Time Frame |
|---|---|---|
| Health Care Utilization for Emergency Department visits proportion and rate per year | The proportion of subjects that utilized the Emergency for a COPD exacerbation | 1 year |
| Health Care Utilization for Hospital Admission proportion and rate per year |
| Measure | Description | Time Frame |
|---|---|---|
| Quality of Life | Improvement of Quality of Life using the CAT score(COPD Assessment Test) | 1 year |
| Improvement in Knowledge of COPD and confidence in self-management | Improvement in Bristol COPD Knowledge Questionnaire and patient self report |
Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Christopher Licskai | Lawson Health Research Institution | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Amherstburg FHT | Amherstburg | Ontario | N9V 0B4 | Canada | ||
| Chatham-Kent FHT |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30923313 | Derived | Ferrone M, Masciantonio MG, Malus N, Stitt L, O'Callahan T, Roberts Z, Johnson L, Samson J, Durocher L, Ferrari M, Reilly M, Griffiths K, Licskai CJ; Primary Care Innovation Collaborative. The impact of integrated disease management in high-risk COPD patients in primary care. NPJ Prim Care Respir Med. 2019 Mar 28;29(1):8. doi: 10.1038/s41533-019-0119-9. |
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| ID | Term |
|---|---|
| D029424 | Pulmonary Disease, Chronic Obstructive |
| ID | Term |
|---|---|
| D008173 | Lung Diseases, Obstructive |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D002908 | Chronic Disease |
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| ID | Term |
|---|---|
| D019090 | Case Management |
| ID | Term |
|---|---|
| D010347 | Patient Care Planning |
| D003191 | Comprehensive Health Care |
| D010346 | Patient Care Management |
| D006298 | Health Services Administration |
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The proportion of subjects that were admitted to hospital for a COPD exacerbation An exacerbation is defined as an increase in or the onset of more than one respiratory symptom (cough, sputum, sputum purulence, wheezing, or dyspnea) lasting 3 days or more and requiring treatment with an antibiotic or a systemic corticosteroid. Respiratory status had to return to baseline for at least 72 hours before another exacerbation would be counted.
| 1 year |
| Severe Exacerbation proportion and rate per year | The proportion of subjects experiencing one or more exacerbations in the study interval. An exacerbation diary will be completed for each event. | 1 year |
| 1 year |
| Process of Care | Process of care: have written action plan, used action plan, advised to quit smoking, offered pharmacologic help with quitting, quit smoking, current packs/day, diagnosis confirmed by spirometry, vaccination rates, instructed on inhaler technique, vaccination rates | 1 year |
| Dyspnea Improvement | Change in dyspnea using the modified MRC questionnaire - Medical Research Council (MRC). | 1 year |
| Disease control | Disease control using the Clinical COPD questionnaire (CCQ) | 1 year |
| Symptom Profile | Change in Symptom profile (cough, wheeze, sputum production) | 1 year |
| Forced Expiratory Volume at 1sec (FEV1) % predicted | FEV1 | 1 year |
| Proportion of Patients on therapy appropriate to their stage of disease | Evaluate medication prescribed related to stage of disease | 1 year |
| Chatham |
| Ontario |
| N7L 5K5 |
| Canada |
| Harrow FHT | Harrow | Ontario | NOR 1G0 | Canada |
| Leamington FHT | Leamington | Ontario | N8H 1N8 | Canada |
| D020969 |
| Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |