Case Management - Active Telephone Support to Patients With COLD

Active Support to Patient With COLD

To investigate the effects of patient counseling by telephone on Quality of Life and the use of Health care system.

By analyzing patient data, patients with risk of high consumption of the Health system are identified.

These patients are invited to take part in the study. If the patient accept the invitation, oral and written information of the study is given. If the patient give informed consent to participate, the inclusion and exclusion criteria and the patient record are examined.

If the patient meet the criteria the patient is randomized to active treatment or control 1:1.

Patient in the Intervention Group have a in depth interview of Health and social status and possible interventions are planned. Following that, the patient is contacted by telephone on weekly intervals for 6 to 9 months.

Patients in both Groups fill out questionaire Short-Form Health Survey-36 (SF-36) and COPD Assessment Test (COPD) and the consumption of Health care is monitored.

Inclusion Criteria:

• Patient living in The Zealand Region.
• A COLD-related contact with hospital with-in 6 months.
• Predicted to be in high risk of new hospital admission.

Exclusion Criteria:

• Dementia.
• Psychosis.
• Drug-addiction.
• Cancer with metastasis.
• Terminal illness.
• Language difficulties demanding translator.