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Effects of the "Living well with COPD" intervention in primary care: a comparative study.

  • Steurer-Stey C Institute of Primary Care, University of Zurich, Zurich, Switzerland claudia.steurer-stey@uzh.ch.
  • Dalla Lana K Institute of Primary Care, University of Zurich, Zurich, Switzerland.
  • Braun J Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
  • Ter Riet G Dept of General Practice, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
  • Puhan MA Epidemiology, Biostatistics and Prevention Institute, University of Zurich, Zurich, Switzerland.
  • 2018-01-06
Published in:
  • The European respiratory journal. - 2018
Aged
Disease Progression
Dyspnea
Exercise Tolerance
Female
Health Behavior
Humans
Logistic Models
Male
Middle Aged
Patient Compliance
Primary Health Care
Prospective Studies
Pulmonary Disease, Chronic Obstructive
Quality of Life
Self Care
Switzerland
English The pivotal objective of chronic obstructive pulmonary disease (COPD) self-management programmes is behaviour change to avoid moderate and severe exacerbations and improve health related quality of life.In a prospectively planned, controlled study, COPD patients who participated in the "Living well with COPD" (LWWCOPD) self-management intervention were compared with usual care patients from the primary care COPD Cohort ICE COLD ERIC, who did not receive self-management intervention (NCT00706602) The primary outcome was behaviour change and disease-specific health related quality of life after 1 year. Secondary end-points included exacerbation rates. We calculated mixed linear, zero-inflated negative binomial and logistic regression models and used propensity scores to counteract confounding.467 patients, 71 from the LWWCOPD and 396 from the usual care cohort, were included. The differences between intervention and control were 0.54 (95% CI 0.13-0.94) on the Chronic Respiratory Questionnaire domain "mastery", 0.55 (95% CI 0.11-0.99) on "fatigue", 0.54 (0.14-0.93) on "emotional function" and 0.64 (95% CI 0.14-1.14) on "dyspnoea". The intervention considerably reduced the risk of moderate and severe exacerbations (incidence rate ratio 0.36, 95% CI 0.25-0.52).Self-management coaching in primary care improves health-related quality of life and lowers exacerbation rates and health care use.
Language
  • English
Open access status
bronze
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Persistent URL
https://sonar.ch/global/documents/47437
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