Taylor, Stephanie JC, Sohanpal, Ratna, Bremner, Stephen A, Devine, Angela, McDaid, David, Fernández, José-Luis, Griffiths, Chris J and Eldridge, Sandra (2012) Self-management support for moderate-to-severe chronic obstructive pulmonary disease: a pilot randomised controlled trial. British Journal of General Practice, 62 (603). pp. 687-695. ISSN 0960-1643
Background Better self management could improve quality of life (QoL) and reduce hospital admissions in chronic obstructive pulmonary disease (COPD), but the best way to promote it remains unclear. Aim To explore the feasibility, effectiveness and cost effectiveness of a novel, layperson-led, theoretically driven COPD self-management support programme. Design and setting Pilot randomised controlled trial in one UK primary care trust area. Method Patients with moderate to severe COPD were identified through primary care and randomised 2:1 to the 7-week-long, group intervention or usual care. Outcomes at baseline, 2, and 6 months included self-reported health, St George's Respiratory Questionnaire (SGRQ), EuroQol, and exercise. Results Forty-four per cent responded to GP invitation, 116 were randomised: mean (standard deviation [SD]) age 69.5 (9.8) years, 46% male, 78% had unscheduled COPD care in the previous year. Forty per cent of intervention patients completed the course; 35% attended no sessions; and 78% participants completed the 6-month follow-up questionnaire. Results suggest that the intervention may increase both QoL (mean EQ-5D change 0.12 (95% confidence interval [CI] = -0.02 to 0.26) higher, intervention versus control) and exercise levels, but not SGRQ score. Economic analyses suggested that with thresholds of £20 000 per quality-adjusted life-year gained, the intervention is likely to be cost-effective. Conclusion This intervention has good potential to meet the UK National Institute for Health and Clinical Excellence criteria for cost effectiveness, and further research is warranted. However, to make a substantial impact on COPD self-management, it will also be necessary to explore other ways to enable patients to access self-management education.
|Additional Information:||© 2012 The Authors|
|Library of Congress subject classification:||R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine|
|Sets:||Research centres and groups > Personal Social Services Research Unit (PSSRU)|
|Date Deposited:||05 Oct 2012 15:55|
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