Coordination of care for patients with COPD: Clinical points of interest

Kasteleyn, Marise J.; Bonten, Tobias; Taube, Christian; Chavannes, Niels H.

doi:10.1177/2053434515620223

Cited by 4 publications

(5 citation statements)

References 37 publications

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“…Physicians should stimulate and evaluate adherence to therapy. Therapy adherence can be increased by raising awareness with the patient of the disease and by improving care cooperation [49] between different healthcare providers and patients [50]. To evaluate adherence, questionnaires can be filled out in the waiting room.…”

Section: Expert Commentarymentioning

confidence: 99%

Morning symptoms in COPD: a treatable yet often overlooked factor

Buul

Kasteleyn

Chavannes

et al. 2017

Expert Review of Respiratory Medicine

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Chronic obstructive pulmonary disease (COPD) patients experience the morning as the worst period of the day. Nevertheless, morning symptoms are not mentioned in COPD guidelines. Areas covered: Different topics on morning symptoms are covered in this review to underline their importance: occurrence, tools for assessment and therapies to limit morning symptoms. Expert commentary: Morning symptoms are common and have a negative influence on a patient's life. Pharmacotherapy seems to be effective in decreasing morning symptoms. A validated tool to assess morning symptoms is lacking. Therefore, more research should focus on assessing morning symptoms with a validated tool to further prove the effect of (pharmaco-) therapy. This will hopefully result in inclusion of morning symptoms in future guidelines.

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Section: Expert Commentarymentioning

confidence: 99%

Morning symptoms in COPD: a treatable yet often overlooked factor

Buul

Kasteleyn

Chavannes

et al. 2017

Expert Review of Respiratory Medicine

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“…Moreover, a major challenge of eHealth in care coordination is to make it beneficial and easy to use for health care providers and patients, otherwise neither will use it [24]. Also, online self-management support needs to be a fully integrated element of IDM.…”

Section: Introductionmentioning

confidence: 99%

“…Previous eHealth studies have revealed the challenges, barriers, and factors that make successful implementation difficult, yet many questions remain unanswered. Moreover, a major challenge of eHealth in care coordination is to make it beneficial and easy to use for health care providers and patients, otherwise neither will use it [ 24 ]. Also, online self-management support needs to be a fully integrated element of IDM.…”

Section: Introductionmentioning

confidence: 99%

High Level of Integration in Integrated Disease Management Leads to Higher Usage in the e-Vita Study: Self-Management of Chronic Obstructive Pulmonary Disease With Web-Based Platforms in a Parallel Cohort Design

Talboom-Kamp¹,

Verdijk²,

Kasteleyn³

et al. 2017

J Med Internet Res

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BackgroundWorldwide, nearly 3 million people die of chronic obstructive pulmonary disease (COPD) every year. Integrated disease management (IDM) improves disease-specific quality of life and exercise capacity for people with COPD, but can also reduce hospital admissions and hospital days. Self-management of COPD through eHealth interventions has shown to be an effective method to improve the quality and efficiency of IDM in several settings, but it remains unknown which factors influence usage of eHealth and change in behavior of patients.ObjectiveOur study, e-Vita COPD, compares different levels of integration of Web-based self-management platforms in IDM in three primary care settings. The main aim of this study is to analyze the factors that successfully promote the use of a self-management platform for COPD patients.MethodsThe e-Vita COPD study compares three different approaches to incorporating eHealth via Web-based self-management platforms into IDM of COPD using a parallel cohort design. Three groups integrated the platforms to different levels. In groups 1 (high integration) and 2 (medium integration), randomization was performed to two levels of personal assistance for patients (high and low assistance); in group 3 there was no integration into disease management (none integration). Every visit to the e-Vita and Zorgdraad COPD Web platforms was tracked objectively by collecting log data (sessions and services). At the first log-in, patients completed a baseline questionnaire. Baseline characteristics were automatically extracted from the log files including age, gender, education level, scores on the Clinical COPD Questionnaire (CCQ), dyspnea scale (MRC), and quality of life questionnaire (EQ5D). To predict the use of the platforms, multiple linear regression analyses for the different independent variables were performed: integration in IDM (high, medium, none), personal assistance for the participants (high vs low), educational level, and self-efficacy level (General Self-Efficacy Scale [GSES]). All analyses were adjusted for age and gender.ResultsOf the 702 invited COPD patients, 215 (30.6%) registered to a platform. Of the 82 patients in group 1 (high integration IDM), 36 were in group 1A (personal assistance) and 46 in group 1B (low assistance). Of the 96 patients in group 2 (medium integration IDM), 44 were in group 2A (telephone assistance) and 52 in group 2B (low assistance). A total of 37 patients participated in group 3 (no integration IDM). In all, 107 users (49.8%) visited the platform at least once in the 15-month period. The mean number of sessions differed between the three groups (group 1: mean 10.5, SD 1.3; group 2: mean 8.8, SD 1.4; group 3: mean 3.7, SD 1.8; P=.01). The mean number of sessions differed between the high-assistance and low-assistance groups in groups 1 and 2 (high: mean 11.8, SD 1.3; low: mean 6.7, SD 1.4; F1,80=6.55, P=.01). High-assistance participants used more services (mean 45.4, SD 6.2) than low-assistance participants (mean 21.2, SD 6.8; F1,80=6.82, P=.01). No as...

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“…Although patient attitudes and receptiveness toward eHealth applications are promising in certain groups of age and education [ 22 , 23 , 24 ], large-scale adoption of eHealth in daily practice still lags behind predictions in comparison with the explosive growth of other digital tools like Facebook and Twitter [ 25 ] (also, during recent years, online banking acceptance has increased rapidly worldwide [ 26 ]). A major challenge of eHealth in care coordination is to make it beneficial and easy to use for both health care providers and patients [ 27 ]. It is important that online self-management support is a fully integrated element of IDM; COPD and asthma patients tended to use an online application on a regular basis when the caregiver was involved, whereas patients on their own used the application only sporadically [ 28 ].…”

Section: Introductionmentioning

confidence: 99%

The Effect of Integration of Self-Management Web Platforms on Health Status in Chronic Obstructive Pulmonary Disease Management in Primary Care (e-Vita Study): Interrupted Time Series Design

et al. 2017

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BackgroundWorldwide nearly 3 million people die from chronic obstructive pulmonary disease (COPD) every year. Integrated disease management (IDM) improves quality of life for COPD patients and can reduce hospitalization. Self-management of COPD through eHealth is an effective method to improve IDM and clinical outcomes.ObjectivesThe objective of this implementation study was to investigate the effect of 3 chronic obstructive pulmonary disease eHealth programs applied in primary care on health status. The e-Vita COPD study compares different levels of integration of Web-based self-management platforms in IDM in 3 primary care settings. Patient health status is examined using the Clinical COPD Questionnaire (CCQ).MethodsThe parallel cohort design includes 3 levels of integration in IDM (groups 1, 2, 3) and randomization of 2 levels of personal assistance for patients (group A, high assistance, group B, low assistance). Interrupted time series (ITS) design was used to collect CCQ data at multiple time points before and after intervention, and multilevel linear regression modeling was used to analyze CCQ data.ResultsOf the 702 invited patients, 215 (30.6%) registered to a platform. Of these, 82 participated in group 1 (high integration IDM), 36 in group 1A (high assistance), and 46 in group 1B (low assistance); 96 participated in group 2 (medium integration IDM), 44 in group 2A (high assistance) and 52 in group 2B (low assistance); also, 37 participated in group 3 (no integration IDM). In the total group, no significant difference was found in change in CCQ trend (P=.334) before (–0.47% per month) and after the intervention (–0.084% per month). Also, no significant difference was found in CCQ changes before versus after the intervention between the groups with high versus low personal assistance. In all subgroups, there was no significant change in the CCQ trend before and after the intervention (group 1A, P=.237; 1B, P=.991; 2A, P=.120; 2B, P=.166; 3, P=.945).ConclusionsThe e-Vita eHealth-supported COPD programs had no beneficial impact on the health status of COPD patients. Also, no differences were found between the patient groups receiving different levels of personal assistance.Trial RegistrationNetherlands Trial Registry NTR4098; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4098 (Archived by WebCite at http://www.webcitation.org/6sbM5PayG)

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Coordination of care for patients with COPD: Clinical points of interest

Cited by 4 publications

References 37 publications

Morning symptoms in COPD: a treatable yet often overlooked factor

Morning symptoms in COPD: a treatable yet often overlooked factor

High Level of Integration in Integrated Disease Management Leads to Higher Usage in the e-Vita Study: Self-Management of Chronic Obstructive Pulmonary Disease With Web-Based Platforms in a Parallel Cohort Design

The Effect of Integration of Self-Management Web Platforms on Health Status in Chronic Obstructive Pulmonary Disease Management in Primary Care (e-Vita Study): Interrupted Time Series Design

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