Saskia Weldam1, Marieke Schuurmans2, Pieter Zanen1,
Alfred Sachs3, Monique Heijmans4 and Jan-Willem Lammers1
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.
was to assess whether the COPD-GRIP intervention in primary care is
more effective in improving HRQoL of COPD patients compared to usual
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.
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.
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.