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Does an educational intervention for untreated COPD and cardiovascular disease which is integrated in an existing lung cancer screening program improve guideline concordant medication adherence at 12 months
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Control Arm: CVD | No Intervention | Patients diagnosed with mild to severe CAC and not on first line guideline recommended therapy. Coronary artery Calcification (CAC) score obtained from lung cancer screening CT Scan images | |
| Intervention Arm: CVD | Other | Patients diagnosed with mild to severe CAC and not on first line guideline recommended therapy. CAC score obtained from lung cancer screening CT Scan images |
|
| Control Arm: COPD | No Intervention | Patients with untreated COPD or not on first line guideline recommended therapy. | |
| Intervention Arm: COPD | Other | Patients with untreated COPD or not on first line guideline recommended therapy. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Educational material and treatment recommendations for patients, general practitioners and pharmacists | Behavioral | Educational material and treatment recommendations given to patients, their family doctors and their pharmacists. |
| Measure | Description | Time Frame |
|---|---|---|
| Guideline concordant statin therapy 1 year following the first low dose CT scan. | Among patients with moderate to severe coronary artery calcifications (CAC) not on a statin at baseline, any statin prescribed for primary prevention at least once in the 1 year following the first low dose CT scan. (aim 1) | 1 year post CT |
| Guideline concordant inhaler therapy 1 year following the first low dose CT scan | Among patients who have untreated or inappropriately treated COPD at baseline, any long acting muscarinic antagonist inhaler prescribed at least once in the 1 year following the first low dose CT scan (aim 2) | 1 year post CT |
| Measure | Description | Time Frame |
|---|---|---|
| Medication possession ratio (MPR) - Aim 1 | Reflects patient adherence. Days of drug supply over 1 year with cholesterol lowering medication in the previous 1 year from pharmacy dispensation records. | 1 year post CT |
| Medication possession ratio (MPR) - Aim 2 |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| McGill University Health Center | Montreal | Quebec | H3K 2M2 | Canada |
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| ID | Term |
|---|---|
| D029424 | Pulmonary Disease, Chronic Obstructive |
| D000080842 | Undiagnosed Diseases |
| D055118 | Medication Adherence |
| ID | Term |
|---|---|
| D008173 | Lung Diseases, Obstructive |
| D008171 | Lung Diseases |
| D012140 | Respiratory Tract Diseases |
| D002908 | Chronic Disease |
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| ID | Term |
|---|---|
| D058005 | General Practitioners |
| D010595 | Pharmacists |
| ID | Term |
|---|---|
| D010820 | Physicians |
| D006282 | Health Personnel |
| D005159 | Health Care Facilities Workforce and Services |
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Reflects patient adherence. Days of drug supply over 1 year with guideline concordant inhaler therapy for COPD in the previous 1 year from pharmacy dispensation records. |
| 1 year post CT |
| COPD Symptoms | COPD Assessment Test is a validated patient-reported outcome. It measures 8 symptoms of COPD on a 0-5 point scale at baseline, 6 and 12 months post intervention | Baseline, 6 months post intervention, 12 months post intervention |
| Quality of life using SF-36 questionnaire | SF-36 questionnaire will be filled at baseline and 12 months post intervention | Baseline, 12 months post intervention |
| Patient satisfaction with communication and decision making | COMRADE is a 20-item self-reported measure for use in primary care to assess risk communication and confidence in treatment decision making. It assesses patient satisfaction with information provided about risks/benefits of treatment, perception of participation in treatment decisions, and satisfaction with that decision. COMRADE questionnaire will be sent to patients after their first meeting with their general practitioner up to 3 months after intervention. | 3 months post intervention |
| Health Care Utilisation | Number of unplanned clinic visits, hospitalizations for respiratory or cardiac disease, consultations with specialists (cardiology and respirology), invasive/non-invasive cardiac or respiratory investigations | 1 year post intervention |
| Absenteeism and presenteeism | Work productivity and activity impairment (WPAI) questionnaire | baseline |
| Health literacy | Health literacy will be assessed at study entry using the Brief Health Literacy Screen. | baseline |
| D020969 |
| Disease Attributes |
| D010335 | Pathologic Processes |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D010349 | Patient Compliance |
| D010342 | Patient Acceptance of Health Care |
| D000074822 | Treatment Adherence and Compliance |
| D015438 | Health Behavior |
| D001519 | Behavior |