None listed
Conditions
Brief summary
Background There is debate about the effectiveness of written COPD action plans. A recent study by Bischoff et al (Thorax 2011) showed that adherence to a COPD action plan was associated with reduced time for exacerbation recovery. There are several barriers to adherence with a COPD action plan, such as: *The practicalities of the patient obtaining the relevant prescribed medications from the pharmacy at a time when the patient is unwell. *The indiscriminate us of relevant prescribed medication This study will test the effect of removing one of these barriers. For this pragmatic pilot study the COPD action plan, from the Australian Lung Foundation (ALF) will be utilised The Respiratory Chronic Care Program provides, regular planned home visits, offering continuing health support through education and assistance to patients, carers and their families. The program augments existing respiratory services by enhancing communicating and coordination of care between hospital, community and general partitioners. Primary Aim Is to provide a written action plan to COPD patients to assess whether dispensing antibiotic and prednisone leads to: *Better adherence with a written action plan *Better health outcomes Over 9 months compared with prescription “only” without dispensing these medications Secondary Aims *For the RCC team to gain an appreciation and understanding for research *Providing pragmatic data for future research and funding Reference: Effects of written action plan adherence on COPD exacerbation recovery. Bischoff E, Hamd D, Sedeno M et al. Thorax 2011;66:26-31
Interventions
A written COPD action plan provided with dispensed antibiotics and steriods.
The COPD action plan is that recommended by the Thoracic Society of Australia and New Zealand and the Australian Lung Foundation.
This plan outlines (in one A4 sheet) a patients usual medication regime, the symptoms of and medications to be taken with a moderate exacerbation, as well as instructions on seeking emergency assistance with symptoms of a severe attack/ exacerbation. This is signed by the patients p
A written COPD action plan provided with dispensed antibiotics and steriods. The COPD action plan is that recommended by the Thoracic Society of Australia and New Zealand and the Australian Lung Foundation. This plan outlines (in one A4 sheet) a patients usual medication regime, the symptoms of and medications to be taken with a moderate exacerbation, as well as instructions on seeking emergency assistance with symptoms of a severe attack/ exacerbation. This is signed by the patients physicain and or GP. The patient keeps a copy with them in case of exacerbation. The provision and level of education provided with this Action Plan is at the descretion of the Doctor writing it. Within the Respiratory Chronic Care program patients are visited regularly by case managers with Action Plan education and reminders provided on case management home visits, these visits usually last approximately 20 to 30 minutes. These visit are attended based on clients coping ability and community support need. Therefore it varies between patients as to frequency. Within the Respiratory Chronic Care program the minimum frequency at which visit are attended is monthly. There is no recommendation as to how often these plans are to be reviewed yet RCC has a policy of updating these every 12 months unless otherwise indicated. The medications on this action plan are also dispensed at the discretion of the treating doctor, at times no script or medication is provided , other times a script and medication is provided on the same day and some patients are provided with a script only. Prednisolone and antibiotics specific to respiratory infections are the medications usually prescribed.
Sponsors
Royal Prince Alfred Hospital
Study design
Allocation
Randomised controlled trial
Intervention model
Parallel
Primary purpose
Treatment
Masking
Open (masking not used)
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
Physician Diagnosis of COPD Post bronchodilator FEV1/FVC <0.7 Patient is enrolled in the respiratory chronic care program- a program based at Royal Prince Alfred Hospital Sydney Australia that provides regular planned home vists for patients with COPD, within Royal Prince Alfred hospitals catchment area.The program offers continuing health support through education and assistance to patients and their carers. This program augments existing respiratory services by enhancing communication and coordination of care between hospital, community services and general practitioners. This care is provided by specialist nurses and physiotherapists.
Exclusion criteria
Treating clinician or respiratory chronic care team believes that the patient is unsuitable eg poor comprehension, inability to follow an action plan Severe uncontroled other diseases that would likely interfere with study outcomes. Active malignancy other than skin cancer.
Outcome results
None listed