Program of Integrated Care for Patients with Chronic Obstructive Pulmonary Disease and Multiple Comorbidities (PIC COPD + ): a randomised controlled trial

What is it about?

Most COPD patients have a number of other conditions that influence symptoms and need for healthcare. Treatment goals focus on symptom relief and preventing exacerbation. However many COPD patients fail to recognize exacerbation early resulting in delayed treatment, longer exacerbation duration, exacerbation of their other conditions, as well as increased need to visit the emergency department (ED) visits or be admitted to hospital. We sought to evaluate if a multi-component, case manager-led exacerbation prevention/management model could reduce ED visits, the need for hospitalization, and death. This management model, implemented in two centres, included individualized care/action plans and telephone case manager telephone consults (12-weekly then 9-monthly). We compared this model to existing care. We included 470 patients (236 case-manager-led model; 234 existing care) and found no differences in the number of ED visits or hospital admissions. However, fewer patients in the case-manager-led model died. We did find a difference in the number of ED visits in those patients that visited the ED, with less visits in patients receiving the case-manager-led model. Similarly, we found fewer hospital admissions for those patients requiring hospital admission, in patients managed by a case manager.

Featured Image