Chronic Obstructive Pulmonary Disease Clinical Trial
Official title:
A Comprehensive Care Programme for Patients With Chronic Obstructive Pulmonary Disease
Objective: Chronic obstructive pulmonary disease (COPD) is a disease with significant morbidity and incurs heavy utilization of healthcare resources. The direct cost of hospital admissions related to COPD is the single largest source of expenditure in the public hospital system. This study aims to assess whether a comprehensive care programme can decrease the rate of hospital admissions for COPD patients.
Design: A randomised controlled trial of patients discharged from hospital after an episode
of acute exacerbation of COPD. Patients will be randomised to the intervention arm or usual
care group.
Setting: Tertiary University affiliated Hospital.
Interventions:
The Intervention group will receive a comprehensive programme which involves inputs from
doctors, respiratory nurses and physiotherapists, providing an individualized care plan for
each subject. The components in the programme will include optimization of medications,
specialist physician follow up, nursing support in education, and physiotherapist support
for pulmonary rehabilitation. Patients in the intervention group will also receive monthly
telephone calls by a respiratory nurse for a period of 1 year to assess their conditions and
answer their queries. Patients will also be followed up in the respiratory clinic by
respiratory specialist once every 3 months for 1 year.
The control group will be managed as the usual care. The discharging physician will
determine the patients' medication and follow up as in normal practice.
All patients will be asked to return for assessments (spirometry, 6 minute walk test,
questionnaires on the severity of dyspnoea and quality of life) at baseline and 12 months
Main outcome measures: The primary endpoint is the hospital readmission rate and the
secondary endpoints are the quality of life, mortality, lung function and exercise capacity
of the patients.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Parallel Assignment, Masking: Single Blind (Outcomes Assessor), Primary Purpose: Treatment
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