Effectiveness of the Assessment of Burden of COPD tool: a cluster-randomised controlled trial

• Published in: Nederlands tijdschrift voor geneeskunde Vol. 160; p. D955
• Main Authors: van Schayck, O C P, Slok, A H M, Kotz, D, van Breukelen, G, Chavannes, N H, Rutten-van Mölken, M P M H, Kerstjens, H A M, van der Molen, T, Asijee, G M, Dekhuijzen, P N R, Holverda, S, Salomé, P L, Goossens, L M A, Twellaar, M, In 't Veen, J C C M
• Format: Journal Article
• Language: Dutch
• Published: Netherlands 2016
• Subjects: Aged; Female; Humans; Male; Middle Aged; Primary Health Care - methods; Pulmonary Disease, Chronic Obstructive - therapy; Quality Improvement; Quality of Life; Surveys and Questionnaires
• ISSN: 0028-2162; 1876-8784

Assessment of the effectiveness of the Assessment of Burden of COPD (ABC) tool on disease-specific quality of life in patients with Chronic Obstructive Pulmonary Disease (COPD). Cluster-randomised controlled trial. This concerned a trial in 39 Dutch primary care practices and 17 hospitals, involving 357 patients with COPD (postbronchodilator FEV1/FVC ratio < 0.7) aged ≥ 40 years. Healthcare providers were randomized to an intervention or control group. Patients in the intervention group were treated with the ABC tool. This innovative tool consists of a short validated questionnaire and a number of objective parameters, which collectively give a visual overview of the combined integral health; the tool subsequently produces an individualized treatment plan by means of a treatment algorithm. Patients in the control group received usual care. The primary outcome measure was the proportion of patients with a clinically relevant improvement in disease-specific quality of life measured, as measured by means of the St. George's Respiratory Questionnaire (SGRQ) score, between baseline and 18 months follow-up. Secondary outcomes included the SGRQ total score and the Patient Assessment of Chronic Illness Care (PACIC) score. At 18-month follow-up, a significant and clinically relevant improvement in the SGRQ score was seen in 34% of the patients (N=49) in the intervention group, and in the control group this figure was 22% (N=33). This difference between the two groups was significant (OR 1.85, 95% CI 1.08 to 3.16). Patients in the intervention group experienced a higher quality of care than patients in the control group (0.32 points difference in PACIC, 95% CI 0.14 to 0.50). Use of the ABC tool increases the disease-specific quality of life and the quality of care for COPD patients; it may therefore offer a valuable contribution to improvements in the daily care of COPD. Replication of this study in other (non-Dutch) health-care settings is recommended.