Assessment of a primary and tertiary care integrated management model for chronic obstructive pulmonary disease

Bolíbar, Ignasi; Plaza, Vicente; Llauger, Mariantònia; Amado, Ester; Antón, Pedro A.; Espinosa, Ana; Domínguez, Leandra; Fraga, Mar; Freixas, Montserrat; de la Fuente, Josep A.; Liguerre, Iskra; Medrano, Casimira; Peiro, Meritxell; Pou, Mariantònia; Sanchis, Joaquin; Solanes, Ingrid; Valero, Carles; Valverde, Pepi
January 2009
BMC Public Health;2009, Vol. 9 Issue 1, p1
Academic Journal
Background: The diagnosis and treatment of patients with chronic obstructive pulmonary disease (COPD) in Spain continues to present challenges, and problems are exacerbated when there is a lack of coordinated follow-up between levels of care. This paper sets out the protocol for assessing the impact of an integrated management model for the care of patients with COPD. The new model will be evaluated in terms of 1) improvement in the rational utilization of health-care services and 2) benefits reflected in improved health status and quality of life for patients. Methods/Design: A quasi-experimental study of the effectiveness of a COPD management model called COPD PROCESS. The patients in the study cohorts will be residents of neighborhoods served by two referral hospitals in Barcelona, Spain. One area comprises the intervention group (n = 32,248 patients) and the other the control group (n = 32,114 patients). The study will include pre- and post-intervention assessment 18 months after the program goes into effect. Analyses will be on two datasets: clinical and administrative data available for all patients, and clinical assessment information for a cohort of 440 patients sampled randomly from the intervention and control areas. The main endpoints will be the hospitalization rates in the two health-care areas and qualityof- life measures in the two cohorts. Discussion: The COPD PROCESS model foresees the integrated multidisciplinary management of interventions at different levels of the health-care system through coordinated routine clinical practice. It will put into practice diagnostic and treatment procedures that are based on current evidence, multidisciplinary consensus, and efficient use of available resources. Care pathways in this model are defined in terms of patient characteristics, level of disease severity and the presence or absence of exacerbation. The protocol covers the full range of care from primary prevention to treatment of complex cases.


Related Articles

  • Nurse-led COPD project is cost-effective. Moberly, Tom // Independent Nurse;10/5/2009, p8 

    The article focuses on the programme of exercise and education led by primary care trust (PCT) nurses in the Isle of Wight which had been proven to improve the quality of life for patients suffering from chronic obstructive pulmonary diseases (COPD). The programme's first batch of participants...

  • RECODE: Design and baseline results of a cluster randomized trial on cost-effectiveness of integrated COPD management in primary care. Kruis, Annemarije L.; Boland, Melinde R. S.; Schoonvelde, Catharina H.; Assendelfl, Willem J. J.; Rutten-van Mölken, Maureen P. M. H.; Gussekloo, Jacobijn; Tsiachristas, Apostolos; Chavannes, Niels H. // BMC Pulmonary Medicine;2013, Vol. 13 Issue 1, p1 

    Background: Favorable effects of formal pulmonary rehabilitation in selected moderate to severe COPD patients are well established. Few data are available on the effects and costs of integrated disease management (IDM) programs on quality of care and health status of COPD patients in primary...

  • Integrated disease management improves one-year quality of life in primary care COPD patients: a controlled clinical trial. Chavannes, Niels H.; Grijsen, Marlous; van den Akker, Marjan; Schepers, Huub; Nijdam, Maddy; Tiep, Brian; Muris, Jean // Primary Care Respiratory Journal;Sep2009, Vol. 18 Issue 3, p171 

    Aim: To assess the long-term effectiveness of an integrated disease management (IDM) program (consisting of optimal medication, reactivation, education, and exacerbation management) in primary care patients with chronic obstructive pulmonary disease (COPD). Method: Controlled trial comparing the...

  • Protocol for assessing inhaler technique in patients with asthma. Joels, Claire // Nursing Standard;1/11/2012, Vol. 26 Issue 19, p43 

    This article outlines the prevalence of asthma in the UK and the importance of consistent and frequent monitoring of inhaler technique in providing improved care to patients with asthma. A protocol for assessing inhaler technique is proposed to improve equity of care and achieve optimum symptom...

  • The primary care face of COPD. Booker, Rachel // Primary Health Care;Jun2008, Vol. 18 Issue 5, p37 

    The article focuses on chronic obstructive pulmonary disease (COPD). The COPD is a long-term condition and a primary care problem that places burdens on patients, health service, and others. Early diagnosis and long-term care are important in decreasing the burden of COPD that allows patients...

  • Improving the Differential Diagnosis of Chronic Obstructive Pulmonary Disease in Primary Care. Price, David B.; Yawn, Barbara P.; Jones, Rupert C. M. // Mayo Clinic Proceedings;Dec2010, Vol. 85 Issue 12, p1122 

    Chronic obstructive pulmonary disease (COPD) and asthma represent a substantial portion of primary care practice. In adults, differentiating asthma from COPD can be difficult but is important because of the marked differences in treatment, disease progression, and outcomes between the 2...

  • Breathing NEW LIFE into COPD care. Boldy, David // Practice Nurse;5/27/2005, Vol. 29 Issue 10, p46 

    Focuses on the support of doctors and primary care for an effort to reduce the number of chronic obstructive pulmonary disease (COPD) patients hospitalised because of exacerbations in Great Britain. Number of deaths caused by COPD every year; Services for patients with the disease to improve...

  • Evaluation of a combined strategy directed towards health-care professionals and patients with chronic obstructive pulmonary disease (COPD): Information and health education feedback for improving clinical monitoring and quality-of-life. Valero, Carles; Monteagudo, Mònica; Llagostera, Maria; Bayona, Xavier; Granollers, Sílvia; Acedo, Mateo; Ferro, Juan J.; Rodríguez-Latre, Lluïsa; Almeda, Jesús; Muñoz, Laura // BMC Public Health;2009, Vol. 9 Issue 1, p442 

    Background: Chronic obstructive pulmonary disease (COPD) is a health problem that is becoming increasingly attended-to in Primary Care (PC). However, there is a scarcity of healthcare programs and studies exploring the implementation of Clinical Practice Guidelines (CPG). The principal objective...

  • A pilot study of identification and case management of high-risk COPD patients in a general practice. Gruffydd-Jones, Kevin; Richman, Jo; Jones, Rupert C. M.; Xu Wang // Family Practice;Oct2010, Vol. 27 Issue 5, p494 

    Background. A variety of individual therapeutic interventions have been shown to reduce hospital admissions and improve quality of life in patients with chronic obstructive pulmonary disease (COPD). However, there is a paucity of data of looking at the effect of case management in primary care...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics