Chronic Obstructive Pulmonary Disease Clinical Trial
Official title:
Disability and Health Outcomes in COPD
To test a conceptual model of how disability develops in chronic obstructive pulmonary disease (COPD).
BACKGROUND:
Background. COPD is a common chronic health condition. Because current medical treatments
have minimal impact on disease progression, a strategy to prevent COPD-related disability
would have important clinical and public health benefits.
DESIGN NARRATIVE:
The study will test a specific conceptual model of how disability develops in COPD. The aims
are: (1) To evaluate the impact of respiratory impairment, especially pulmonary function
impairment, on the risk of functional limitation in COPD. Using a control group, to
elucidate the prevalence of respiratory impairment, functional limitation, and disability
that is directly attributable to COPD. (2) In adults with COPD, to delineate the
longitudinal effect of functional limitation on the risk of incident disability. The
investigators hypothesize that development of functional limitation, and not pulmonary
function impairment, is the major determinant of disability. (3) To determine the
prospective impact of disability on the risk of future adverse health outcomes. The
investigators will assemble a prospective cohort of 1200 randomly sampled adults with COPD
who are members of a large regional health maintenance organization. A matched control group
of 300 subjects will be recruited. Subjects will undergo a detailed physical assessment that
measures respiratory impairment (e.g., pulmonary function) and functional limitation (e.g.,
lower extremity function, muscle strength, exercise performance, and cognitive function).
Structured telephone interviews will ascertain disability outcomes at baseline and 18-month
prospective follow-up. The investigators will also study the modulating effects of specific
risk factors and protective factors on the progression from functional limitation to
COPD-related disability, including psychological factors, environmental exposures, and
health care process factors.
;
Observational Model: Case Control, Time Perspective: Prospective
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