Effectiveness of the Assessment of Burden of Chronic Obstructive Pulmonary Disease (ABC) tool: study protocol of a cluster randomised trial in primary and secondary care

Abstract

BackgroundChronic Obstructive Pulmonary Disease (COPD) is a growing worldwide problem that imposes a great burden on the daily life of patients. Since there is no cure, the goal of treating COPD is to maintain or improve quality of life. We have developed a new tool, the Assessment of Burden of COPD (ABC) tool, to assess and visualize the integrated health status of patients with COPD, and to provide patients and healthcare providers with a treatment algorithm. This tool may be used during consultations to monitor the burden of COPD and to adjust treatment if necessary. The aim of the current study is to analyse the effectiveness of the ABC tool compared with usual care on health related quality of life among COPD patients over a period of 18 months.Methods/DesignA cluster randomised controlled trial will be conducted in COPD patients in both primary and secondary care throughout the Netherlands. An intervention group, receiving care based on the ABC tool, will be compared with a control group receiving usual care. The primary outcome will be the change in score on a disease-specific-quality-of-life questionnaire, the Saint George Respiratory Questionnaire. Secondary outcomes will be a different questionnaire (the COPD Assessment Test), lung function and number of exacerbations. During the 18 months follow-up, seven measurements will be conducted, including a baseline and final measurement. Patients will receive questionnaires to be completed at home. Additional data, such as number of exacerbations, will be recorded by the patients’ healthcare providers. A total of 360 patients will be recruited by 40 general practitioners and 20 pulmonologists. Additionally, a process evaluation will be performed among patients and healthcare providers.DiscussionThe new ABC tool complies with the 2014 Global Initiative for Chronic Obstructive Lung Disease guidelines, which describe the necessity to classify patients on both their airway obstruction and a comprehensive symptom assessment. It has been developed to classify patients, but also to provide visual insight into the burden of COPD and to provide treatment advice.Trial registrationNetherlands Trial Register, NTR3788.

‘To use or not to use’: a qualitative study to evaluate experiences of healthcare providers and patients with the assessment of burden of COPD (ABC) tool

“…41 This reply card included postage for mailing, the address of the university and check boxes to indicate whether the researchers were allowed to contact the patient by telephone or not. Over 60 patients (almost 40%) replied that they were willing to be contacted for an interview.…”

Assessment of Burden of COPD (ABC) tool: perceptionversusevidence

“…Second, the rationale, hypothesis, objectives and methodology seem incoherent. The ABC assessment tool was originally developed to "assess and visualize the integrated health status of patients with COPD, and to provide patients and healthcare providers with a treatment algorithm" [20]. Further, the authors mention that the ABC tool can be used as a communication tool in primary and hospital care.…”

“…On the other hand "it provides the opportunity to support personalized care planning" [19]. The study protocol stated that "it has been developed to classify patients, but also to provide visual insight into the burden of COPD and to provide treatment advice" [20]. The authors hypothesised that the ABC tool "… will influence self-management, facilitate and stimulate behaviour change …" [19].…”

“…The ABC tool is a computer program visualising these outcomes using coloured balloons (figure 1) [19]. It was originally developed to "assess and visualize the integrated health status of patients with COPD, and to provide patients and healthcare providers with a treatment algorithm" [20]. The ABC tool has recently been evaluated in a randomised control trial in primary and secondary care settings in the Netherlands studying the effectiveness compared with usual care on health status in the management of patients with COPD over a period of 18 months [19].…”

Does pIgR Down-Regulation in COPD Cause Reprogramming of Bronchial Epithelium?

“…Although it is a preventable and treatable disease, there is no cure [1]. It is associated with considerable morbidity and is predicted to become the third most common cause of mortality [2].…”