A chronic disease management programme can reduce days in hospital for patients with chronic obstructive pulmonary disease

Abstract

A chronic disease management programme for COPD patients that incorporated a variety of interventions, including pulmonary rehabilitation and implemented by primary care, reduced admissions and hospital bed days. Key elements were patient participation and information sharing among healthcare providers.

Systematic review of integrated models of health care delivered at the primary–secondary interface: how effective is it and what determines effectiveness?

“…One RCT showed improvements in wellbeing (Smith et al 2004). In programs for respiratory disease and heart failure, some of the quality of life subscale scores improved (Doughty et al 2002;Rea et al 2004).…”

“…Study quality was mixed, with the RCTs (Doughty et al 2002;Pearl et al 2003;Rea et al 2004;Smith et al 2004;Coast et al 2005;Salisbury et al 2005;Borgermans et al 2009;Goderis et al 2010) demonstrating low to medium risk of bias and the nonrandomised trials (Simmons 2003;Nocon et al 2004;Kirsh et al 2007;Sheridan et al 2009;Askew et al 2010;Jackson et al 2010) demonstrating medium to high risk (Table 2). A full appraisal of the risk of bias in the included studies is available in Appendix 2.…”

“…The majority of studies related to patients with diabetes (n = 6; Simmons 2003; Nocon et al 2004;Smith et al 2004;Kirsh et al 2007;Borgermans et al 2009;Askew et al 2010;Goderis et al 2010;Jackson et al 2010). Three were from New Zealand (Doughty et al 2002;Pearl et al 2003;Rea et al 2004;Sheridan et al 2009), two each from Australia (Simmons 2003;Askew Jackson et al 2010;Jackson Tsai et al 2010) and the UK (Nocon et al 2004;Coast et al 2005;Salisbury et al 2005), with the remaining three from the US (Kirsh et al 2007), Belgium (Borgermans et al 2009;Goderis et al 2010) and Ireland (Smith et al 2004). One study was an RCT Salisbury et al 2005), four were cluster RCTs (Doughty et al 2002;Pearl et al 2003;Rea et al 2004;Smith et al 2004;Borgermans et al 2009;Goderis et al 2010), three reported a quasi-experimental design (Nocon et al 2004;Kirsh et al 2007;Askew et al 2010;Jackson et al 2010) and two used a pre-post design (Simmons 2003;Sheridan et al 2009).…”

“…Three were from New Zealand (Doughty et al 2002;Pearl et al 2003;Rea et al 2004;Sheridan et al 2009), two each from Australia (Simmons 2003;Askew Jackson et al 2010;Jackson Tsai et al 2010) and the UK (Nocon et al 2004;Coast et al 2005;Salisbury et al 2005), with the remaining three from the US (Kirsh et al 2007), Belgium (Borgermans et al 2009;Goderis et al 2010) and Ireland (Smith et al 2004). One study was an RCT Salisbury et al 2005), four were cluster RCTs (Doughty et al 2002;Pearl et al 2003;Rea et al 2004;Smith et al 2004;Borgermans et al 2009;Goderis et al 2010), three reported a quasi-experimental design (Nocon et al 2004;Kirsh et al 2007;Askew et al 2010;Jackson et al 2010) and two used a pre-post design (Simmons 2003;Sheridan et al 2009). Eight studies used quantitative methods (Doughty et al 2002;Pearl et al 2003;Simmons 2003;Rea et al 2004;Smith et al 2004;Coast et al 2005;Salisbury et al 2005;Kirsh et al 2007;Borgermans et al 2009;Askew et al 2010;Goderis et al 2010;Jackson et al 2010), whereas two used a mixed-methods approach …”

“…One study was an RCT Salisbury et al 2005), four were cluster RCTs (Doughty et al 2002;Pearl et al 2003;Rea et al 2004;Smith et al 2004;Borgermans et al 2009;Goderis et al 2010), three reported a quasi-experimental design (Nocon et al 2004;Kirsh et al 2007;Askew et al 2010;Jackson et al 2010) and two used a pre-post design (Simmons 2003;Sheridan et al 2009). Eight studies used quantitative methods (Doughty et al 2002;Pearl et al 2003;Simmons 2003;Rea et al 2004;Smith et al 2004;Coast et al 2005;Salisbury et al 2005;Kirsh et al 2007;Borgermans et al 2009;Askew et al 2010;Goderis et al 2010;Jackson et al 2010), whereas two used a mixed-methods approach (Nocon et al 2004;Sheridan et al 2009). …”