Self-management support for moderate-to-severe chronic obstructive pulmonary disease: a pilot randomised controlled trial

Taylor, Stephanie JC, Sohanpal, Ratna, Bremner, Stephen A, Devine, Angela, McDaid, David ORCID: 0000-0003-0744-2664, Fernández, José-Luis ORCID: 0000-0002-4190-7341, 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

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Abstract

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

Item Type:	Article
Official URL:	http://www.rcgp.org.uk/Publications/BJGP.aspx
Additional Information:	© 2012 British Journal of General Practice.
Divisions:	Care Policy and Evaluation Centre
Subjects:	R Medicine > RA Public aspects of medicine
Date Deposited:	30 Oct 2012 12:57
Last Modified:	06 Nov 2024 18:27
URI:	http://eprints.lse.ac.uk/id/eprint/47147

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