Martin 2004.
Study characteristics | |
Methods | Design: RCT Follow‐up: 12 months Control group: usual care |
Participants |
Recruitment: general practice Assessed for eligibility: not reported Randomly assigned: SM: 44; UC: 49 Completed: SM: 35; UC: 45 Mean age: SM: 71.1 (95% CI 68.7 to 73.5) years; UC: 69.1 (95% CI 63.5 to 74.7) years Gender (% male): SM: 34.1; UC: 65.3 COPD diagnosis: GOLD criteria (FEV1/FVC ratio < 0.7), confirmed by authors Inclusion of participants in acute phase: no (use of the plan was commenced at a time when each participant was in a stable condition) Major inclusion criteria: diagnosis of COPD, aged 55 or over, at least one hospital admission or two acute exacerbations of COPD requiring GP care during the previous 12 months, an MMSE score > 22 Major exclusion criteria: terminally ill, coexisting lung cancer, admission to hospital with cardiac disease within previous 12 months, receiving home oxygen therapy |
Interventions |
Mode: individual sessions at a general practice, hospital, ambulance service, emergency department or home‐based Duration: 4 face‐to‐face individual sessions and respiratory nurse visits at 3, 6 and 12 months Professional: respiratory physician, respiratory nurse, GP, ED consultant, medical staff Assignment of case managers: no Self‐management components: use of a COPD exacerbation action plan, COPD medication intake, guidance regarding treatment for coexisting conditions (e.g. when/how to use oxygen therapy, and when to use diuretics) Self‐management topics: smoking cessation, coping with breathlessness/breathing techniques, self‐recognition of exacerbations Behavioural change techniques: 3 clusters: goals and planning, feedback and monitoring, shaping knowledge |
Outcomes | 1. Health care utilisation (GP visits, hospital admissions, ambulance calls) 2. Quality of life (SGRQ) 3. Medication use (courses of oral steroids and antibiotics) |
Notes | Three participants subsequently withdrew for personal reasons. However, it was not reported from which group(s) they withdrew. A further 13 people died during the follow‐up period (nine in the intervention group and four in the control group). Source of funding: this study was supported by South Link Health Inc., a nonprofit consortium of general practitioners. Conflict of interest: none declared |