Program of integrated care for patients with chronic obstructive pulmonary disease and multiple comorbidities (PIC COPD+): a randomised controlled trial
Louise Rose, Laura Istanboulian, Lise Carriere, Anna Thomas, et al.
Eur Respir J 2018;51:1701567.
The purpose of this trial was to ascertain whether a multi-component, case manager-led exacerbation prevention/management model reduced emergency department visits of people with two or more chronic obstructive pulmonary disease (COPD)-associated comorbidities. Secondary outcomes included hospitalisation, mortality, health-related quality of life, COPD severity, COPD self-efficacy, anxiety and depression.
In this study, Louise Rose of the University of Toronto and her colleagues compared their multi-component intervention (which included individualised care/action plans and telephone consults) with usual care (in each of the two centres involved in the trial). The 470 participants were randomised, with no differences in the number of emergency department visits or hospital admissions between groups. However, differences were detected in emergency department visit risk, in favour of the intervention. There was also a lower risk of hospital admission in the intervention group for those requiring hospital admission, with the risk of death nearly half that of the control (21 versus 36). There were no differences in the other secondary outcomes.