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Definition of a COPD self-management intervention: International Expert Group consensus

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Saskia Weldam1, Marieke Schuurmans2, Pieter Zanen1, Alfred Sachs3, Monique Heijmans4 and Jan-Willem Lammers1
1Department of Respiratory Diseases, University Medical Center Utrecht, Utrecht, Netherlands, 2Department of Rehabilitation, Nursing Science & Sports, University Medical Center Utrecht, Utrecht, Netherlands, 3Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, Netherlands, 4Health Research, Netherlands Institute for Health Services Research (NIVEL), Utrecht, Netherlands

Background: The new nurse-led COPD-Guidance, Research on Illness Perception (COPD-GRIP) intervention translates the evidence concerning illness perceptions and Health Related Quality of Life (HRQoL) into a care plan to guide COPD patients and to improve HRQoL.

The aim: was to assess whether the COPD-GRIP intervention in primary care is more effective in improving HRQoL of COPD patients compared to usual care.

Method: A pragmatic, two arm cluster randomized controlled trial was conducted within 35 general practices throughout the Netherlands in 204 COPD patients GOLD I-IV (NTR3945).Of 17 practices, 103 patients were randomly assigned to the intervention group and of 18 practices 101 patients to the usual care group. To assess differences for all continues outcomes, repeated linear mixed modelling (LMM) analyses were used. Primary outcome was change in HRQoL on the Clinical COPD Questionnaire (CCQ) at 9 months. Secondary outcomes were daily activities, health education impact and illness perceptions.

Results: After 6 weeks there was an improvement in the CCQ, in illness perceptions and health-directed activities within the intervention group, however no statistical difference was seen between the groups in the CCQ at 9 months (mean difference -0.21, 95% confidence interval -0.6 up to 0.2; P=0.32). No statistical differences were seen in the secondary outcomes.

Conclusion: Our results show a benefit of the COPD-GRIP intervention in the short term, however the results do not support the benefit of the COPD-GRIP intervention in improving HRQoL in the longer term.

Source :
Image :

PDPI Malang. 23/10/17.

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