Warm homes for older people: aims and methods of a randomised community-based trial for people with COPD
Open accessAbstract
BACKGROUND: Chronic Obstructive Pulmonary Disease (COPD) is of increasing importance with about one in four people estimated to be diagnosed with COPD during their lifetime. None of the existing medications for COPD has been shown to have much effect on the long-term decline in lung function and there have been few recent pharmacotherapeutic advances. Identifying preventive interventions that can reduce the frequency and severity of exacerbations could have important public health benefits. The Warm Homes for Elder New Zealanders study is a community-based trial, designed to test whether a NZ$500 electricity voucher paid into the electricity account of older people with COPD, with the expressed aim of enabling them to keep their homes warm, results in reduced exacerbations and hospitalisation rates. It will also examine whether these subsidies are cost-beneficial. METHODS: Participants had a clinician diagnosis of COPD and had either been hospitalised or taken steroids or antibiotics for COPD in the previous three years; their median age was 71 years. Participants were recruited from three communities between 2009 to early 2011. Where possible, participants' houses were retrofitted with insulation. After baseline data were received, participants were randomised to either 'early' or 'late' intervention groups. The intervention was a voucher of $500 directly credited to the participants' electricity company account. Early group participants received the voucher the first winter they were enrolled in the study, late participants during the second winter. Objective measures included spirometry and indoor temperatures and subjective measures included questions about participant health and wellbeing, heating, medication and visits to health professionals. Objective health care usage data included hospitalisation and primary care visits. Assessments of electricity use were obtained through electricity companies using unique customer numbers. DISCUSSION: This community trial has successfully enrolled 522 older people with COPD. Baseline data showed that, despite having a chronic respiratory illness, participants are frequently cold in their houses and economise on heating. TRIAL REGISTRATION: The clinical trial registration is http://NCT01627418.
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In the Warm Homes for Elder New Zealanders Study, participants assigned to the first intervention group showed no significant health gain, although secondary analyses suggested a lower mortality rate among participants assigned to the intervention group.
“Participants assigned to the first intervention group showed no significant health gain, although secondary analyses suggested a lower mortality rate among participants assigned to the intervention group (169).”
From Review of the Impact of Housing Quality on Inequalities in Health and Well-Being (2023) · cites this paper as [169]
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- Authors
- Viggers, H., Howden-Chapman, P., Ingham, T., Chapman, R., Pene, G., Davies, C., Currie, A., Pierse, N., Wilson, H., Zhang, J., Baker, M., & Crane, J.
- Affiliations
- University of Otago (NZ)
- Victoria University of Wellington (NZ)
- Tū Kotahi Māori Asthma Trust (NZ)
- Canterbury District Health Board (NZ)
- Corresponding author
- Viggers, Helen
- ORCID
- Venue
- BMC Public Health
- Published
- 2013-02-26
- Volume
- 13
- Issue
- 1
- Pages
- 176-176
- ISSN
- 1471-2458 (ISSN-L)
- PMC
- PMC3608967
- OpenAlex
- W2048318493
- Cited by
- 29
- References
- 63
- Citations by year
- 2025: 5 · 2023: 1 · 2022: 2 · 2021: 2 · 2020: 5 · 2019: 2 · 2018: 1 · 2017: 5 · 2016: 3 · 2015: 1 · 2014: 2
- FWCI
- 1.63
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- BMC Public Health (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- University of Otago
- Health Research Council of New Zealand (HRC 09/071)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Physical Sciences › Environmental Science › Pollution › Energy and Environment Impacts
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Keywords
- chronic obstructive pulmonary disease, older adults, residential heating, COPD exacerbations, hospitalization, home insulation, energy subsidies, cost-effectiveness, indoor temperature, health care utilization
- MeSH terms
- Aged, Aged, 80 and over, Community Health Services, Cost-Benefit Analysis, Electricity, Female, Heating, Hospitalization, Housing, Humans, Male, Middle Aged, New Zealand, Research Design, Program Evaluation, Pulmonary Disease, Chronic Obstructive
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
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