Community-based Management of Chronic Obstructive Pulmonary Disease in Nepal

Protocol for Community-based Management of Chronic Obstructive Pulmonary Disease in Nepal: a Community-based Cluster Randomized Controlled Trial

Chronic Obstructive Pulmonary Disease (COPD) is the fourth most important cause of death worldwide and is one of the commonest non-communicable diseases (NCDs) in Nepal. The presence of risk factors like indoor and outdoor air pollution, the high prevalence of smoking and lack of general awareness of COPD makes it a serious public health concern. However, no attempt has been made in Nepal to estimate its burden and address the disease at the community level. This community-based cluster randomized controlled study aims to fulfil that gap through mobilization of Female Community Health Workers (FCHVs) who will be trained to perform a certain set of health promotion activities aimed at prevention of the disease and its progression. Baseline and follow-up surveys will be conducted to compare the intervention and control groups. This study has the potential to generate evidence in helping address NCDs in Nepal and also other similar resource-limited countries.

Inclusion Criteria:

• Capable of performing spirometry
• Aged greater than and equal to 40 years
• Full time residents in the study area and will be in the study area for at least one year

Exclusion Criteria:

• Younger than 40 years of age
• Self-reported pregnancy
• having active pulmonary tuberculosis or being on medications for pulmonary tuberculosis
• thoracic, abdominal or eye surgery in the last six months
• History of Mental illness
• MI in past 8 weeks prior to study
• Hospital admission in the past six months for cardiac illness
• Those who decline to provide consent to the study will be excluded.