The DOI matches its Crossref record; 25 of the 25 references it cites were found in a registry or an index.
Reduction of Hospital Utilization in Patients With Chronic Obstructive Pulmonary Disease<subtitle>A Disease-Specific Self-management Intervention</subtitle>
Abstract
BACKGROUND: Self-management interventions improve various outcomes for many chronic diseases. The definite place of self-management in the care of chronic obstructive pulmonary disease (COPD) has not been established. We evaluated the effect of a continuum of self-management, specific to COPD, on the use of hospital services and health status among patients with moderate to severe disease. METHODS: A multicenter, randomized clinical trial was carried out in 7 hospitals from February 1998 to July 1999. All patients had advanced COPD with at least 1 hospitalization for exacerbation in the previous year. Patients were assigned to a self-management program or to usual care. The intervention consisted of a comprehensive patient education program administered through weekly visits by trained health professionals over a 2-month period with monthly telephone follow-up. Over 12 months, data were collected regarding the primary outcome and number of hospitalizations; secondary outcomes included emergency visits and patient health status. RESULTS: Hospital admissions for exacerbation of COPD were reduced by 39.8% in the intervention group compared with the usual care group (P =.01), and admissions for other health problems were reduced by 57.1% (P =.01). Emergency department visits were reduced by 41.0% (P =.02) and unscheduled physician visits by 58.9% (P =.003). Greater improvements in the impact subscale and total quality-of-life scores were observed in the intervention group at 4 months, although some of the benefits were maintained only for the impact score at 12 months. CONCLUSIONS: A continuum of self-management for COPD patients provided by a trained health professional can significantly reduce the utilization of health care services and improve health status. This approach of care can be implemented within normal practice.
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Cited by
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Self-citationPulmonary rehabilitation for chronic obstructive pulmonary disease
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Self-citationCOPD exacerbations: Defining their cause and prevention
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Metadata
- Authors
- Bourbeau, J.
- Venue
- Archives of Internal Medicine
- Publisher
- American Medical Association (AMA)
- Published
- 2003-03-10
- Volume
- 163
- Issue
- 5
- Pages
- 585
- ISSN
- 0003-9926 (ISSN-L)
- OpenAlex
- W2155638685
- Cited by
- 939
- References
- 25
- FWCI
- 28.96
- Type
- journal article
- Language
- en
- Open access
- closed
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