The COPDX Plan: Australian and New Zealand Guidelines for the management of Chronic Obstructive Pulmonary Disease 2003

McKenzie, David K.; Frith, Peter

doi:10.5694/j.1326-5377.2003.tb05213.x

Cited by 155 publications

(224 citation statements)

References 174 publications

(233 reference statements)

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“…Participants’ GPs and HMs received a COPD management plan corresponding to Australian guideline recommendations18 based on each individual participant's COPD baseline assessment (see online supplementary appendix 2).…”

Section: Methodsmentioning

confidence: 99%

Effects of telephone health mentoring in community-recruited chronic obstructive pulmonary disease on self-management capacity, quality of life and psychological morbidity: a randomised controlled trial

et al. 2013

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ObjectivesTo assess benefits of telephone-delivered health mentoring in community-based chronic obstructive pulmonary disease (COPD).DesignCluster randomised controlled trial.SettingTasmanian general practices: capital city (11), large rural (3), medium rural (1) and small rural (16).ParticipantsPatients were invited (1207) from general practitioner (GP) databases with COPD diagnosis and/or tiotropium prescription, response rate 49% (586), refused (176) and excluded (criteria: smoking history or previous study, 68). Spirometry testing (342) confirmed moderate or severe COPD in 182 (53%) patients.RandomisationBy random numbers code, block stratified on location, allocation by sequentially numbered, opaque and sealed envelopes.InterventionHealth mentor (HM) group received regular calls to manage illness issues and health behaviours from trained community health nurses using negotiated goal setting: problem solving, decision-making and action planning. Control: usual care (UC) group received GP care plus non-interventional brief phone calls.OutcomesMeasured at 0, 6 and 12 months, the Short Form 36 (SF-36) and St George’s Respiratory Questionnaire (SGRQ, primary); Partners In Health (PIH) Scale for self-management capacity, Hospital Anxiety and Depression Scale (HADS), Center for Epidemiologic Studies-Depression (CES-D) questionnaire, Post-Traumatic Stress Disorder Checklist, Satisfaction with life and hospital admissions (secondary).Results182 participants with COPD (age 68±8 years, 62% moderate COPD and 53% men) were randomised (HM=90 and UC=92). Mixed model regression analysis accounting for clustering, adjusting for age, gender, smoking status and airflow limitation assessed efficacy (regression coefficient, β, reported per 6-month visit). There was no difference in quality of life between groups, but self-management capacity increased in the HM group (PIH overall 0.15, 95% CI 0.03 to 0.29; knowledge domain 0.25, 95% CI 0.00 to 0.50). Anxiety decreased in both groups (HADS A 0.35; 95% CI −0.65 to −0.04) and coping capacity improved (PIH coping 0.15; 95% CI 0.04 to 0.26).ConclusionsHealth mentoring improved self-management capacity but not quality of life compared to regular phone contact, which itself had positive effects where decline is generally expected.

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Section: Methodsmentioning

confidence: 99%

Effects of telephone health mentoring in community-recruited chronic obstructive pulmonary disease on self-management capacity, quality of life and psychological morbidity: a randomised controlled trial

et al. 2013

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“…In practices receiving either intervention, GPs and other nominated staff were trained during a 2 h workshop (see appendix 1) by a physiologist and respiratory specialist physician in performance of spirometry (theory and practice), interpretation and criteria for diagnosing COPD according to Global Initiative for Chronic Obstructive Lung Disease (GOLD)4 and Australian5 guidelines (forced expiratory volume in 1 s/forced vital capacity (FEV 1 /FVC) <0.7).…”

Section: Methodsmentioning

confidence: 99%

“…Previously unrecognised airflow obstruction was found in 19% of current smokers over 35 years of age in general practice3 and although spirometry is essential for the diagnosis of COPD,4 5 performing spirometry in primary care is not without difficulties. These include lack of access to reliable equipment, lack of training, patient reluctance to travel and financial disincentives 6 – 8.…”

mentioning

confidence: 99%

A mixed methods study to compare models of spirometry delivery in primary care for patients at risk of COPD

Walters

Hansen

Johns

et al. 2008

Thorax

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Background: To increase recognition of airflow obstruction in primary care, we compared two models of spirometry delivery in a target group at risk of chronic obstructive pulmonary disease (COPD). Methods: A 6 month qualitative/quantitative cluster randomised study in eight practices compared opportunistic spirometry by ''visiting trained nurses'' (TN) with optimised ''usual care'' (UC) from general practitioners (GPs) for smokers and ex-smokers, aged over 35 years. Outcomes were: spirometry uptake and quality, new diagnoses of COPD and GPs' experiences of spirometry. Results: In the eligible target population, 531/904 (59%) patients underwent spirometry in the TN model and 87/ 1130 (8%) patients in the UC model (p,0.0001). ATS spirometry standards for acceptability and reproducibility were met by 76% and 44% of tests in the TN and UC models, respectively (p,0.0001). 125 (24%) patients tested with the TN model and 38 (44%) with the UC model reported a pre-existing respiratory diagnosis (p,0.0001). Three months after spirometry, when the ratio of forced expiratory volume in 1 s/forced vital capacity (FEV 1 /FVC) was ,0.7 and no prior COPD diagnosis was reported, nine (8%) participants had a new doctor recorded COPD diagnosis in practices with the TN model and two (8%) participants in practices with the UC model. Mislabelling of participants with a diagnosis of COPD when FEV 1 /FVC was >0.7 was present in both models prior to and after spirometry. GPs valued high quality spirometry and increased testing of patients at risk of COPD in the TN model. They identified limitations, including the need for better systematic follow-up of abnormal spirometry and support with interpretation, which may explain persisting underdiagnosis of COPD in practice records. Conclusions: Although opportunistic testing by visiting trained nurses substantially increased and improved spirometry performance compared with usual care, translating increased detection of airflow obstruction into diagnosis of COPD requires further development of the model.

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“…Diffusing capacity along with spirometry is the cornerstone of the clinical guidelines for the diagnoses of COPD and other pulmonary conditions 8 9. Current measurements are compared with “normal” values which have been calculated using algorithms derived from population studies of healthy volunteers.…”

mentioning

confidence: 99%

Prediction equations for single breath diffusing capacity (Tlco) in a middle aged caucasian population

Thompson

Johns

Bailey

et al. 2008

Thorax

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Background: There are many reference equations for the measurement of single breath carbon monoxide diffusing capacity of the lung (TlCO). However, the testing methodologies vary and there are no well documented studies that have developed reference equations for TlCO and alveolar volume (VA) in middle aged and older populations. Aims: (1) Develop reference equations for TlCO in a middle aged population using the current American Thoracic Society/European Respiratory Society (ATS/ERS) guidelines; (2) compare the equations with those commonly used in laboratories around the world. Methods: Healthy subjects (498 male and 474 female) aged 45-71 years were recruited as part of a larger epidemiological study. All participants completed a respiratory questionnaire and had spirometry and single breath TlCO (corrected for haemoglobin) measurements following ATS/ERS guidelines. Results: Mean age was 58 years for males and 57 years for females. For males, factors that predicted TlCO were: height, age, age6height interaction and being an exsmoker. For females, factors that predicted TlCO were: height, age, weight and an age6height interaction. Conclusion: We have described new prediction equations for TlCO in a middle aged population that require validation in other populations.

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The COPDX Plan: Australian and New Zealand Guidelines for the management of Chronic Obstructive Pulmonary Disease 2003

Cited by 155 publications

References 174 publications

Effects of telephone health mentoring in community-recruited chronic obstructive pulmonary disease on self-management capacity, quality of life and psychological morbidity: a randomised controlled trial

Effects of telephone health mentoring in community-recruited chronic obstructive pulmonary disease on self-management capacity, quality of life and psychological morbidity: a randomised controlled trial

A mixed methods study to compare models of spirometry delivery in primary care for patients at risk of COPD

Prediction equations for single breath diffusing capacity (Tlco) in a middle aged caucasian population

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