None listed
Conditions
Brief summary
COPD is a common problem for current or ex smokers but is often undiagnosed or diagnosed late when the condition has deteriorated significantly. Effective treatment is available so early diagnosis is very important. In this study practice nurses will identify patients who are at risk of COPD and undertake case finding. Patients newly diagnosed with COPD who attend the “intervention practices” will be offered a management involving the GP and practice nurse working in partnership. The patients who attend the “control practices” will receive usual care from their GPs. We will then primarily examine the impact of the “intervention” or the “usual care” on patients' quality of life, health status and lung function and draw a comparison between the two groups in order to asses the effectiveness of the intervention.
Interventions
Practice nurse will work in partnership with the GP and patients newly diagnosed with COPD to develop a care plan, which will contain relevant components of the following: 1) Smoking cessation as per current guidelines for current smokers 2) Immunisation - influenza and pneumococcal vaccination status will be assessed and updated 3) Pulmonary rehabilitation for patients with COPD. 4) Current medications and education about potential future indications for pharmacotherapy will be assessed. For pa
Practice nurse will work in partnership with the GP and patients newly diagnosed with COPD to develop a care plan, which will contain relevant components of the following: 1) Smoking cessation as per current guidelines for current smokers 2) Immunisation - influenza and pneumococcal vaccination status will be assessed and updated 3) Pulmonary rehabilitation for patients with COPD. 4) Current medications and education about potential future indications for pharmacotherapy will be assessed. For patients already using any inhaler, inhaler technique will be checked using published checklists. Patients for whom inhalers are indicated will be educated on the appropriate use of these using established protocols. 5) Nutrition: Advice about diet and exercise and referral to a dietician if appropriate for overweight or underweight patients. 6) Psychosocial issues: identification and management of anxiety and/or depression. 7) Patient education: patients will be provided with written information about COPD and its management and with information about local patient support groups which provide emotional support and self-management information. 8) Co-morbidities and complications of COPD will be assessed and managed. The GP and the practice nurse involved with patient care will decide the frequency of visit and the intervention will be of 12 months duration.
Sponsors
The University of New South Wales
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Blinded (masking used)
Eligibility
Sex/Gender
All
Age
40 Years to 85 Years
Healthy volunteers
No
Inclusion criteria
Inclusion criteria: 1) attended the practice at least twice and with at least one visit in the preceding 12 months 2) aged between 40 and 85 years 3) history of smoking recorded or uncertain
Exclusion criteria
Exclusion criteria: 1) a recorded diagnosis of COPD 2) age less than 40 or greater than 85 3) inability to understand English 4) cognitive impairment
Outcome results
None listed