Wang 2019.
Study characteristics | |
Methods | Design: RCT Follow‐up: 12 months Control group: usual care |
Participants |
Recruitment: hospital (inpatient) Assessed for eligibility: 479 Randomly assigned: SM: 77; UC: 77 Completed: SM: 72; UC: 71 Mean age: SM: 68.7 (SD 6.2) years; UC: 69.2 (SD 6.1) years Gender (% male): SM: 76.6; UC: 80.5 COPD diagnosis: GOLD criteria, confirmed with spirometry (FEV1/FVC ratio < 0.7) Inclusion of participants in acute phase: yes, during hospitalisation Major inclusion criteria: aged 40 years or older; diagnosis of Global Initiative for Chronic Obstructive Lung Disease (GOLD) stage II, III or IV; COPD documented by pulmonary function testing; participants hospitalised for acute exacerbation of COPD; willing to sign an informed consent form Major exclusion criteria: severe sensory or cognitive impairment or symptomatic ischaemic heart disease; a coexisting respiratory condition (e.g. asthma or lung cancer); inability to be contacted by phone/mobile phone; participation in another research program or inability to provide informed consent |
Interventions |
Mode: individual sessions at the hospital and at home; booklet; telephone calls Duration: 5 to 6 face‐to‐face individual sessions (45 min each), 3 home visits (45 to 60 min each), and weekly phone calls scheduled over 3 months (10 to 15 min each) Professional: nurse Assignment of case managers: not reported Self‐management components: smoking cessation (optional), home‐based exercise or physical activity, COPD medication intake (i.e. adherence, inhalation technique), coping with breathlessness, respiratory muscle training (pursed lip breathing and abdominal breathing), coughing techniques, long‐term home oxygen therapy (optional) Self‐management topics: not reported Behavioural change techniques: 5 clusters: goals and planning, feedback and monitoring, social support, shaping knowledge, natural consequeces |
Outcomes | 1. COPD‐related hospital admissons 2. Emergency department visits 3. Exercise tolerance (6MWT) 4. Health‐related quality of life (SGRQ) 5. Participant satisfaction (CTCPSQ) |
Notes | Source of funding: the work described in this paper was supported by a grant from the Education Department of Guizhou Province, China. Conflict of interest: none declared |
AECOPD: acute exacerbations of COPD; ATS: American Thoracic Society; A&E: accident and emergency; BODE: Body‐mass index, airflow Obstruction, Dyspnea, and Exercise; BSI‐18: Brief Symtom Inventory 18; CAT: COPD Assessment Test; CCQ: Clinical COPD Questionnaire; CES‐D: Centers for Epidemiologic Studies – Depression; CHF: congestive heart failure; COPD: chronic obstructive pulmonary disease; CM: collaborative management; CRE: certified respiratory educator; CRQ: Chronic Respiratory (Disease) Questionnaire; CSES: COPD Self‐Efficacy Scale; CSQ: Client Satisfaction Questionnaire; CTCPSQ: COPD Transitional Care Patient Satisfaction Questionnaire; ED: emergency department; ER: emergency room; ESC: European Society of Cardiology; ESWT: Endurance‐Shuttle Walk Test; EuroQol 5D: European Quality of Life Five Dimension; FEV1/FEV1: forced expiratory volume in one second (measured in litres (L)); FVC: forced vital capacity; GOLD: Global initiative for chronic Obstructive Lung Disease; GSE: General Self‐Efficacy Scale; GP: general practitioner; HADS: Hospital Anxiety and Depression Scale; HeiQ: Health education impact Questionnaire; HRQoL: health‐related quality of life; HSI: Heaviness of Smoking Index; ICD: International Classification of Diseases; IHD: ischaemic heart disease; IIRS: Illness Intrusiveness Rating Scale; IPAQ: International Physical Activity Questionnaire; ISWT: Incremental Shuttle Walking Test; MHLC: Multidimensional Health Locus of Control; min: minute(s); MM: medical management; MMSE: Mini Mental State Examination; (m)MRC: (modified) Medical Research Council; PCL‐C: Post‐traumatic Stress Disorder Checklist; PIH: Partners in Health Scale; RCT: randomised controlled trial; SD: standard deviation; SEMCD: Self‐Efficacy for Managing Chronic Disease; SF‐36: 36‐Item Short Form Health Survey; SGRQ: St. George's Respiratory Questionnaire; SGRQ‐C: St. George's Respiratory Questionnaire ‐ COPD‐Specific Version; SIP: Sickness Impact Profile; SM: self‐management; SOC‐13: Sense of Coherence Scale – 13; SR: self‐reported; SWLS: Satisfaction With Life Scale; UC: usual care; 6MWD: six‐minute walk distance