Effects of an Active Implementation of a Guideline for Chronic Obstructive Pulmonary Disease

NCT01228708 | Completed DMC

• 1 other identifier: Active Implementation-FEAA
• Study Type: interventional
• Target: 3,021
• Locations: 0 countries
• Sites: N/A

Brief Summary

Aims: To design a proactive implementation strategy for a chronic-disease-management-programme. To describe effects of the active implementation of a programme for COPD-patients measured on patient-related goals and use of health resources. To describe stakeholders' evaluation of the implementation. Materials and method: An intervention study with 3000 COPD-patients cluster-randomized after a bloc-randomization of their GP-practice. 18 GP-practices in Ringkøbing-Skjern-Municipality are randomized to receive an active implementation or to an "as usual" group. A neighboring municipality acts as "sleeping" control. With data from registers and a questionnaire-survey the effect on COPD-patients self reported-health, evaluation of health system and changes in distribution of health resources is analyzed. How health professionals perceive the implementation and how it influences their conception, interactions and culture is illustrated by interviews with stakeholders. We expect to see improved health related quality of life, enhanced evaluation of the health system and a more appropriate distribution of health resources in the intervention group.

Conditions

Implementation of a Chronic Disease Management Programme; COPD

Keywords

Implementation strategy; Chronic disease management programme; COPD

Outcome Measures

Primary Outcomes (1)

• Changes in COPD-patients self reported-health, their evaluation of the health system and in the distribution of health resources.

  14 months

Secondary Outcomes (1)

• Health professionals

  14 months

Study Arms (3)

Intervention

ACTIVE COMPARATOR

Patients from half the GP practices in Ringkoebing-Skjern municipality that participates in an active implementation of a guideline for COPD

Other: Active implementation of a guideline for chronic disease

Control group

NO INTERVENTION

Patients from the half of the GP practice in Ringkoebing-Skjern that do not participate in the active implementation of a guideline for COPD. The GPs are however in postgraduate training groups with intervention groups GPs

External control

NO INTERVENTION

Patients with GP practice in neighboring county Ikast-Brande where there have been no information or contact at all from the investigators

Interventions

Active implementation of a guideline for chronic disease OTHER

Smoking cessation courses Remuneration to GPs for the planned follow-up and joint home visits Action card and sputum colour advice Webpage on "How to live with COPD" and the support the health system can provide Database with patients with COPD Feed-back from health centre to GPs, when patients have finished courses Fax from hospital to GPs, when patients with COPD is discharged Routines to recall patients for follow-ups Team audit, evaluate and adjust the strategies every 3rd month Joint home visit with GP and community nurse when a patient with COPD is discharged to plan future care Practice staff do part of follow-ups and monitoring Practice supervision with consultant in lung diseases Podcast with advice from specialists Guideline for COPD

Intervention

Eligibility Criteria

• Age: 35 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• People who live in either Ringkoebing-Skjern or Ikast-Brande municipalities and have a GP in the municipality and have been in hospital during the last 5 years with a lung related diagnosis or has redeemed a prescription for medication for lung related problems twice during the last year or has had at least two spirometries done during the last year.

Sponsors & Collaborators

• University of Aarhus: lead
• Research Unit for General Practice, Aarhus University: collaborator
• Ringkoebing-Skjern Municipality, Denmark.: collaborator
• Region MidtJylland Denmark: collaborator

Related Publications (4)

• Smidth M, Christensen MB, Fenger-Gron M, Olesen F, Vedsted P. The effect of an active implementation of a disease management programme for chronic obstructive pulmonary disease on healthcare utilization--a cluster-randomised controlled trial. BMC Health Serv Res. 2013 Oct 3;13:385. doi: 10.1186/1472-6963-13-385.

  PMID: 24090189 DERIVED

• Smidth M, Olesen F, Fenger-Gron M, Vedsted P. Patient-experienced effect of an active implementation of a disease management programme for COPD - a randomised trial. BMC Fam Pract. 2013 Oct 3;14:147. doi: 10.1186/1471-2296-14-147.

  PMID: 24088417 DERIVED

• Smidth M, Christensen MB, Olesen F, Vedsted P. Developing an active implementation model for a chronic disease management program. Int J Integr Care. 2013 Jun 17;13:e020. doi: 10.5334/ijic.994. Print 2013 Apr.

  PMID: 23882169 DERIVED

• Smidth M, Sokolowski I, Kaersvang L, Vedsted P. Developing an algorithm to identify people with Chronic Obstructive Pulmonary Disease (COPD) using administrative data. BMC Med Inform Decis Mak. 2012 May 22;12:38. doi: 10.1186/1472-6947-12-38.

  PMID: 22616576 DERIVED

MeSH Terms

Conditions

Pulmonary Disease, Chronic Obstructive

Condition Hierarchy (Ancestors)

Lung Diseases, Obstructive; Lung Diseases; Respiratory Tract Diseases; Chronic Disease; Disease Attributes; Pathologic Processes; Pathological Conditions, Signs and Symptoms

Study Officials

• Margrethe IC Smidth, PT MSc

  The Research Unit for General Practice Aarhus

  PRINCIPAL INVESTIGATOR

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: NONE
• Purpose: HEALTH SERVICES RESEARCH
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: SPONSOR

Study Record Dates

• First Submitted: October 25, 2010
• First Posted: October 26, 2010
• Study Start: August 1, 2009
• Primary Completion: October 1, 2010
• Study Completion: November 1, 2011
• Last Updated: March 28, 2012

Record last verified: 2012-03