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'The COPD breathlessness manual': a randomised controlled trial to test a cognitive-behavioural manual versus information booklets on health service use, mood and health status, in patients with chronic obstructive pulmonary disease.

Howard C, Dupont S - NPJ Prim Care Respir Med (2014)

Bottom Line: After 12 months, total A&E visits had reduced by 42% in the CM group, compared with a 16% rise in the IB group.At 6 months, there were significantly greater improvements in anxiety (F (2,198)=5.612, P=0.004), depression (F (1.8,176.1)=10.697, P⩽0.001) and dyspnoea (F (2,198)=18.170, P⩽0.001) in the CM group.Estimated savings at 12 months were greatest in the CM group, amounting to £30k or £270 per participant.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Health Psychology, Central and North West London NHS Foundation Trust, The Hillingdon Hospital, Pield Heath Road, Uxbridge, UK.

ABSTRACT

Background: Chronic obstructive pulmonary disease (COPD) is a costly long-term condition associated with frequent Accident and Emergency (A&E) and hospital admissions. Psychological difficulties and inadequate self-management can amplify this picture.

Aims: To compare a cognitive-behavioural manual versus information booklets (IB) on health service use, mood and health status.

Methods: Two hundred and twenty-two COPD patients were randomly allocated to receive either the COPD breathlessness manual (CM) or IB. They were instructed to work through their programme at home, over 5 weeks. Guidance from a facilitator was provided at an initial home visit plus two telephone call follow-ups.

Results: After 12 months, total A&E visits had reduced by 42% in the CM group, compared with a 16% rise in the IB group. The odds of people in the IB group attending A&E 12 months post-intervention was 1.9 times higher than for the CM group (CI 1.05-3.53). Reduction in hospital admissions and bed days were greatest in the CM group. At 6 months, there were significantly greater improvements in anxiety (F (2,198)=5.612, P=0.004), depression (F (1.8,176.1)=10.697, P⩽0.001) and dyspnoea (F (2,198)=18.170, P⩽0.001) in the CM group. Estimated savings at 12 months were greatest in the CM group, amounting to £30k or £270 per participant.

Conclusion: The COPD manual, which addresses physical and mental health, is a straightforward cost-effective intervention that is worth offering to COPD patients within primary or secondary care.

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Related in: MedlinePlus

Trial profile.
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fig1: Trial profile.

Mentions: Simple blocked random sampling was undertaken. Computerised random blocks of six at a time were randomised, three in each group. Participants were blind to group allocation. Primary and secondary care staff were aware of patients’ participation in the trial, but were unaware of group allocation and the trial was separate to any clinical care provided. See Figure 1 for trial profile.


'The COPD breathlessness manual': a randomised controlled trial to test a cognitive-behavioural manual versus information booklets on health service use, mood and health status, in patients with chronic obstructive pulmonary disease.

Howard C, Dupont S - NPJ Prim Care Respir Med (2014)

Trial profile.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4373470&req=5

fig1: Trial profile.
Mentions: Simple blocked random sampling was undertaken. Computerised random blocks of six at a time were randomised, three in each group. Participants were blind to group allocation. Primary and secondary care staff were aware of patients’ participation in the trial, but were unaware of group allocation and the trial was separate to any clinical care provided. See Figure 1 for trial profile.

Bottom Line: After 12 months, total A&E visits had reduced by 42% in the CM group, compared with a 16% rise in the IB group.At 6 months, there were significantly greater improvements in anxiety (F (2,198)=5.612, P=0.004), depression (F (1.8,176.1)=10.697, P⩽0.001) and dyspnoea (F (2,198)=18.170, P⩽0.001) in the CM group.Estimated savings at 12 months were greatest in the CM group, amounting to £30k or £270 per participant.

View Article: PubMed Central - PubMed

Affiliation: Department of Clinical Health Psychology, Central and North West London NHS Foundation Trust, The Hillingdon Hospital, Pield Heath Road, Uxbridge, UK.

ABSTRACT

Background: Chronic obstructive pulmonary disease (COPD) is a costly long-term condition associated with frequent Accident and Emergency (A&E) and hospital admissions. Psychological difficulties and inadequate self-management can amplify this picture.

Aims: To compare a cognitive-behavioural manual versus information booklets (IB) on health service use, mood and health status.

Methods: Two hundred and twenty-two COPD patients were randomly allocated to receive either the COPD breathlessness manual (CM) or IB. They were instructed to work through their programme at home, over 5 weeks. Guidance from a facilitator was provided at an initial home visit plus two telephone call follow-ups.

Results: After 12 months, total A&E visits had reduced by 42% in the CM group, compared with a 16% rise in the IB group. The odds of people in the IB group attending A&E 12 months post-intervention was 1.9 times higher than for the CM group (CI 1.05-3.53). Reduction in hospital admissions and bed days were greatest in the CM group. At 6 months, there were significantly greater improvements in anxiety (F (2,198)=5.612, P=0.004), depression (F (1.8,176.1)=10.697, P⩽0.001) and dyspnoea (F (2,198)=18.170, P⩽0.001) in the CM group. Estimated savings at 12 months were greatest in the CM group, amounting to £30k or £270 per participant.

Conclusion: The COPD manual, which addresses physical and mental health, is a straightforward cost-effective intervention that is worth offering to COPD patients within primary or secondary care.

Show MeSH
Related in: MedlinePlus