Effects of case management on hospitalisation and exacerbation rate in severe, complex COPD: A randomized controlled trial
L. Boer, T. Schermer, A. Koopman, J. Peters, Y. Heijdra, J. Vercoulen, E. van der Heijden (Nijmegen, Netherlands)
Source: Annual Congress 2011 - Exacerbations and severe chronic respiratory disease: oxygen, rehabilitation, admission to hospital and palliative care
Disease area: Airway diseases
Abstract Background Acute exacerbations have negative effects on lung function, physical performance, dyspnoea, and quality of life. Patients with severe COPD and co-morbidities are especially vulnerable to exacerbations.Aim We investigated if a case manager could reduce number and duration of hospital admissions due to exacerbations of COPD.Method In this RCT, 81 COPD patients GOLD stage 3-4 and co-morbid disease, with ≥ 1 reported exacerbation in the past two years were randomised to usual care or a case management care condition. In the usual care condition, patients visited the pulmonary nurse every 3 to 6 months. In the case manager condition, the pulmonary nurse started with a home visit, and contacted patients at least every 6 weeks by phone. Basic self-management techniques were taught and an exacerbation action plan was offered to the patient and all health care providers.Results Number and duration of hospital admissions were not lower in the experimental condition. The number of exacerbations reported by the general practitioner did not differ significantly. No differences were found between the two conditions with respect to health status measured by the CRQ. There was major drop out in both groups (42%), main reason was death (53%). Patients were more satisfied with the experimental condition, particularly because the case manager helped coordinating the complex care by many professionals.Conclusion Positive benefits on health status and hospital admission rates and duration were not found. However, patients with severe COPD and multiple comorbidities benefit from a case manager by structuring care in a better way leading to increased patient satisfaction.
Rating:
You must login to grade this presentation.
Share or cite this content
Citations should be made in the following way:
L. Boer, T. Schermer, A. Koopman, J. Peters, Y. Heijdra, J. Vercoulen, E. van der Heijden (Nijmegen, Netherlands). Effects of case management on hospitalisation and exacerbation rate in severe, complex COPD: A randomized controlled trial. Eur Respir J 2011; 38: Suppl. 55, 1248
You must login to share this Presentation/Article on Twitter, Facebook, LinkedIn or by email.
Member's Comments
Related content which might interest you:
Related content which might interest you:
Late Breaking Abstract - First-time assessment of efficacy of candidate vaccine to prevent acute exacerbations of chronic obstructive pulmonary disease (AECOPD): multicentre, randomised, controlled, observer-blind phase 2b trial Source: Virtual Congress 2021 – ALERT: COPD Year: 2021
Exacerbation action plans for patients with COPD and comorbidities: a randomised controlled trial Source: Eur Respir J, 54 (5) 1802134; 10.1183/13993003.02134-2018 Year: 2019
Early pulmonary rehabilitation after acute exacerbation of COPD: a randomised controlled trial Source: ERJ Open Res, 6 (1) 00173-2019; 10.1183/23120541.00173-2019 Year: 2020
Effect of telehealthcare on exacerbations and hospital admissions in COPD: A randomised controlled trial Source: International Congress 2015 – Best abstracts in pulmonary rehabilitation and chronic care Year: 2015
Does automated oxygen control with O2matic reduce frequency and duration of hypoxemic episodes in patients admitted with exacerbation of COPD? – a randomized controlled trial Source: International Congress 2019 – Airway physiology Year: 2019
Evidence generation for the clinical impact of myCOPD in patients with mild, moderate and newly diagnosed COPD: a randomised controlled trial Source: ERJ Open Res, 6 (4) 00460-2020; 10.1183/23120541.00460-2020 Year: 2020
Lower incidence of asthma exacerbations with FE NO-guided anti-inflammatory treatment: A randomised controlled trial Source: Annual Congress 2012 - Effectiveness of respiratory disease management in primary care Year: 2012
STEP-UP randomized controlled trial of vapor ablation in patients with severe emphysema: 12 month results Source: International Congress 2016 – Endoscopic lung volume reduction I Year: 2016
Efficacy and safety of isoproterenol continuous inhalation treatment for acute severe exacerbation of asthma in children; a randomized, double-blind controlled study Source: International Congress 2015 – Paediatric asthma and allergy: asthma management Year: 2015
Outcomes reported on the management of COPD exacerbations: a systematic survey of randomised controlled trials Source: ERJ Open Res, 5 (2) 00072-2019; 10.1183/23120541.00072-2019 Year: 2019
Acute effects of nasal high-flow during exercise in COPD patients after an exacerbation : a randomized controlled cross-over trial Source: International Congress 2019 – COPD treatment: cardiovascular, oxygen and vaccination studies Year: 2019
Effects of a concomitant therapy with Cineole (Eucalyptole) on exacerbation rate in COPD: A placebo-controlled double-blind trial Source: Annual Congress 2010 - COPD exacerbation Year: 2010
Time-to-treatment failure in the Belgian randomized controlled trial with azithromycin for acute COPD exacerbations requiring hospitalization Source: International Congress 2016 – Highlights in the management of COPD and beyond Year: 2016
ß-blockers in exacerbations of COPD: feasibility of a randomised controlled trial Source: ERJ Open Res, 3 (1) 00090-2016; 10.1183/23120541.00090-2016 Year: 2017
Late Breaking Abstract - Can a self-management plan, which includes a four-fold increase in inhaled corticosteroid dose, reduce severe asthma exacerbations: a randomised, pragmatic trial. Source: International Congress 2017 – Late-breaking findings in asthma and COPD Year: 2017
Patients’ adherence to chronic treatment in lung diseases: Preliminary data from a randomized controlled trial Source: International Congress 2016 – Monitoring airway diseases with clinical tools Year: 2016
Influence of patient baseline characteristics and concomitant medication on outcomes in long-term trials of COPD: Analysis of the UPLIFT® trial Source: Annual Congress 2013 –Clinical trials of LAMAs, LABAs, MABAs and theophylline for asthma and COPD Year: 2013
Formoterol in patients with chronic obstructive pulmonary disease: a randomized, controlled, 3-month trial. Source: Eur Respir J 2002; 20: 245 Year: 2002
Tele-assistance in chronic respiratory failure patients: a randomised clinical trial Source: Annual Congress 2008 - Integrated care and long-term strategies Year: 2008
The effect of low-dose corticosteroids and theophylline on the risk of acute exacerbations of COPD: the TASCS randomised controlled trial Source: Eur Respir J, 57 (6) 2003338; 10.1183/13993003.03338-2020 Year: 2021