COPD Clinical Trial
Official title:
Effectiveness of Standardized Respiratory Physiotherapy in Primary Care in Patients With Mild COPD and Its Economic Assessment
Chronic Obstructive Pulmonary Disease (COPD) is a very important public health problem and
one of the most common lung diseases in the world, with repercussions on mortality and high
economic costs. The World Health Organization estimates that COPD is the fifth most common
disease in the world and the fourth leading cause of death. It is expected to grow in
prevalence and mortality over the coming decades; it is estimated that in 2020, it will be
the third most common cause of death worldwide.
Primary care is the main ambit in the management of these patients, in fact, it is where most
patients with COPD are visited. However, a high proportion of these patients only receive
chest physiotherapy treatment in hospitals, and the implementation of this kind of treatment
in primary care is still very uncommon.
Hypothesis: There is effectiveness on the quality of life and various predictive factors of
mortality (BODE index, six-minute walk distance, FEV1, dyspnea, and body mass index) and the
economic impact of a Standardized Respiratory Physiotherapy program conducted in Primary Care
(FREAP) in patients with moderate COPD at 6 months after its implementation.
AIMS
To evaluate the effectiveness on the quality of life and various predictive factors of
mortality (BODE index, six-minute walk distance, FEV1, dyspnea, and body mass index) and the
economic impact of a Standardized Respiratory Physiotherapy program conducted in Primary Care
(FREAP) in patients with moderate COPD at 6 months after its implementation.
METHOD
Design: Randomized controlled trial
Location: Tarragona-Reus Primary Care Area of the Catalan Health Service. 14 primary care
centres were involved in the project (8 from the Reus-Altebrat Primary Care Service and 6
from the Tarragona-Valls Primary Care Service) and 8 units of physiotherapy.
Participants: 129 patients with moderate COPD treated by primary care teams.
Intervention: FREAP program for 6 months. It consisted of an initial health education session
conducted in the primary care health centre, three sessions a week for three weeks of
breathing exercises and aerobic, physical training in the primary care health centre and a
monthly monitoring appointment for the breathing exercises and training for five months in
the patient's home. Altogether, 10 sessions in the primary care health center and 5 sessions
at the patients' house. Patients randomized in the control group continued with their usual
clinical practice.
Main effect measures: Quality of life (St. George Respiratory Questionnaire -SGRQ-).
Predictive factors of mortality (BODE index, six-minute walk distance, FEV1, dyspnea, and
body mass index). Economic cost of implementing the FREAP program.
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