NCT00128765

Costs and Effects of Three Modes for Disease Management of Chronic Obstructive Pulmonary Disease in General Practice

Costs and Effects of Three Modes for Disease Management of Chronic Obstructive Pulmonary Disease (COPD) in General Practice. A Randomized Controlled Trial Comparing Regular Practice Nurse Review, Self-management Education and Usual Care

• Status: Completed
• Phase: N/A
• Study type: Interventional
• Enrollment: 165 (actual)
• Sponsor: Radboud University Medical Center · Academic / Other
• Sex: All
• Age: 35 Years
• Healthy volunteers: Not accepted

Summary

In this randomized controlled trial, three contemporary modes for chronic obstructive pulmonary disease (COPD) management in Dutch general practices are compared for costs and effects: * usual general practitioner (GP) care (at patient's initiative); * regular practice nurse review; and * integrated self-management education. All three interventions are based on existing guidelines, materials, and field experiences.

Detailed description

Considering the ageing of the Dutch population and the current and increasing shortage of general practitioners (GPs), the capacity of primary healthcare is a major and growing concern. Delegation of care normally provided by GPs with care provided by trained practice nurses is now rapidly emerging for patients with chronic respiratory disease, i.e. asthma and chronic obstructive pulmonary disease (COPD). However, most general practices still provide care at initiative of the patient self, because of the lack in scientific evidence and the costs of implementing a regular care structure. Self-care by patients may be an alternative to alleviate the growing load on primary health care. The following two main research questions are addressed in this study. * Does an integrated self-management education intervention for patients with COPD in general practice contribute to attaining long-term treatment targets, compared to regular monitoring by a practice nurse and usual GP care? * What is the cost-effectiveness of an integrated self-management education intervention for patients with COPD, compared to regular monitoring by a practice nurse and usual GP care?

Conditions

• Lung Diseases, Obstructive

Interventions

Type	Name	Description
BEHAVIORAL	an integrated self-management education program	disease specific self-management program 'Living Well with COPD', developed in Montreal, Canada
BEHAVIORAL	regular practice nurse review (monitoring controls)	protocol based on existing Guidelines: Dutch College of General Practitioners (NHG) Global Initiative for Chronic Obstructive Lung Disease (GOLD)
BEHAVIORAL	care at initiative of the patient (usual GP care)	care at initiative of the patient (usual GP care)

Timeline

• Start date: 2005-01-01
• Primary completion: 2008-12-01
• Completion: 2008-12-01
• First posted: 2005-08-10
• Last updated: 2011-11-22

Locations

1 site across 1 country: Netherlands