Active management boosts patient satisfaction with COPD care

BMC Family Practice 2013; 14: 147

A disease management program (DMP) for chronic obstructive pulmonary disease (COPD) based on the Chronic Care Model leads to greater patient satisfaction with care than standard disease management, a randomized trial suggests.

The DMP emphasized the role of the primary care physician in coordinating care of patients with COPD, a feature that the researchers believe underpinned the greater patient satisfaction they observed.

The DMP was introduced in central Denmark in 2008 and is based on the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines and Danish clinical guidelines.

General practitioner (GP) practices were randomly assigned to implement disease management in the standard way (control practices; n=21) or using an “active, structured” approach that included engagement of a local, esteemed opinion leader, regular meetings between GPs and experienced facilitators, reimbursement for GPs for undertaking home visits with the community nurse, and targeted support for patients suffering exacerbations (intervention practices; n=17). The researchers also recruited an external control group (n=25) involving practices from outside the intervention municipality, to account for a spillover effect to neighboring practices.

The study’s primary outcome was the patients’ assessment of their care, measured with the Patient Assessment of Chronic Illness Care (PACIC) instrument. A total of 744 patients completed the PACIC at both baseline and at 12 months and were included in the analysis.

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