Impact of continuity of care on quality of life in patients with chronic obstructive pulmonary disease

2019 ◽  
Vol 27 (1) ◽  
pp. 26-36
Author(s):  
Ali Bikmoradi ◽  
Azam Jalalinasab ◽  
Mohsen Salvati ◽  
Mohamad Ahmadpanah ◽  
Farshid Divani ◽  
...  

PurposePatients with chronic obstructive pulmonary disease (COPD) suffer many physical disabilities which cause many problems in their life. These patients really need to have continuity of care based on cooperation between patient, the family and their care givers in order to achieve an integration of care. The purpose of this paper is to assess the impact of continuous care on quality of life of patients with COPD.Design/methodology/approachA before–after quasi-experimental study was carried out with 72 patients with COPD at Beheshti educational hospital of Hamadan University of Medical Sciences. The patients who met inclusion criteria were randomly allocated into an intervention group (n=36) and a control group (n=36). The patients completed the St George’s Respiratory Questionnaire before and after their care. The intervention comprised continuous care with orientation and sensitization sessions (2 weeks), control and evaluation sessions (45 days) for intervention group and with routine care in the control group. Data were analyzed with SPSS, descriptive and inferential statistics were conducted to measure differences between intervention and control group.FindingsContinuity of care improved significantly the quality of life of COPD patients in general, and in the symptoms, activity and impact domains (P=0.001). In contrast, routine care did not improve quality of life for patients in general, and in the symptoms, activity and impact domains (P=0.05).Originality/valueContinuity of care has a positive impact on quality of life for COPD patients. Health care system should utilize continuity of care models as an overall plan for patients with COPD. Moreover, managers of health care system could reduce burden of chronic diseases by employing continuity of care models in planning patient care.

2021 ◽  
pp. 1-8
Author(s):  
Yating Zhang ◽  
Xiangfang Zhao

<b><i>Background:</i></b> Chronic obstructive pulmonary disease (COPD) is a chronic respiratory condition. COPD causes a heavy burden on the patients through negative impacts on the quality of life and psychological health. The health belief model (HBM) is proposed and modified by several social psychologists and is confirmed to have benefits in the recovery of various diseases. This research aimed to explore the effects of the HBM-based intervention on anxiety, depression, and quality of life in COPD patients entering pulmonary rehabilitation (PR). <b><i>Methods:</i></b> This research was conducted at the Tianjin Rehabilitation Recuperate Center of Chinese PLA in 2019. A total of 136 COPD patients were randomized into the intervention group and the control group. In the control group, patients received the PR program. In the intervention group, patients received both PR program and the HBM-based intervention. Quality of life was measured by the COPD assessment test. The outcomes of anxiety and depression were measured by the Hospital Anxiety and Depression Scale. <b><i>Results:</i></b> The HBM-based intervention decreased both anxiety and depression scores among COPD patients. The COPD assessment test score was declined by the HBM-based intervention, which also decreased the serum levels of interleukin-6 and C-reactive protein in COPD patients entering PR. <b><i>Conclusion:</i></b> The HBM-based intervention alleviates anxiety and depression, enhances quality of life, and inhibits inflammation in COPD patients entering PR.


2017 ◽  
Author(s):  
Elizabeth Broadbent ◽  
Jeff Garrett ◽  
Nicola Jepsen ◽  
Vickie Li Ogilvie ◽  
Ho Seok Ahn ◽  
...  

BACKGROUND Socially assistive robots are being developed for patients to help manage chronic health conditions such as chronic obstructive pulmonary disease (COPD). Adherence to medication and availability of rehabilitation are suboptimal in this patient group, which increases the risk of hospitalization. OBJECTIVE This pilot study aimed to investigate the effectiveness of a robot delivering telehealth care to increase adherence to medication and home rehabilitation, improve quality of life, and reduce hospital readmission compared with a standard care control group. METHODS At discharge from hospital for a COPD admission, 60 patients were randomized to receive a robot at home for 4 months or to a control group. Number of hospitalization days for respiratory admissions over the 4-month study period was the primary outcome. Medication adherence, frequency of rehabilitation exercise, and quality of life were also assessed. Implementation interviews as well as benefit-cost analysis were conducted. RESULTS Intention-to-treat and per protocol analyses showed no significant differences in the number of respiratory-related hospitalizations between groups. The intervention group was more adherent to their long-acting inhalers (mean number of prescribed puffs taken per day=48.5%) than the control group (mean 29.5%, P=.03, d=0.68) assessed via electronic recording. Self-reported adherence was also higher in the intervention group after controlling for covariates (P=.04). The intervention group increased their rehabilitation exercise frequency compared with the control group (mean difference −4.53, 95% CI −7.16 to −1.92). There were no significant differences in quality of life. Of the 25 patients who had the robot, 19 had favorable attitudes. CONCLUSIONS This pilot study suggests that a homecare robot can improve adherence to medication and increase exercise. Further research is needed with a larger sample size to further investigate effects on hospitalizations after improvements are made to the robots. The robots could be especially useful for patients struggling with adherence. CLINICALTRIAL Australian New Zealand Clinical Trials Registry ACTRN12615000259549; http://www.anzctr.org.au (Archived by WebCite at  http://www.webcitation.org/6whIjptLS)


2011 ◽  
Vol 18 (5) ◽  
pp. e77-e81 ◽  
Author(s):  
Manon Labrecque ◽  
Khalil Rabhi ◽  
Catherine Laurin ◽  
Helene Favreau ◽  
Gregory Moullec ◽  
...  

OBJECTIVE: To assess the effects of a self-management program on health-related quality of life (HRQoL) and morbidity commonly associated with chronic obstructive pulmonary disease (COPD).METHODS: A total of 57 outpatients with stable COPD received four weeks of self-management education, while 45 patients received usual care. Patients were evaluated at baseline, at three months and one year following the educational intervention. The primary outcome variable was HRQoL measured by the St George’s Respiratory Questionnaire (SGRQ). The secondary outcome variables were number of emergency room visits and hospitalizations for exacerbation.RESULTS: The intervention group’s HRQoL improved significantly at three months (total score A=−5.0 [P=0.006]) and 12 months (total score A=−6.7 [P<0.001]), as evidenced by decreased scores on the SGRQ. In contrast, the SGRQ scores increased significantly in the control group at three months (total score A=+3.7 [P= 0.022]) and 12 months (total score A=+3.4 [P=0.032]). Global impact appeared to be responsible for the change in the intervention group. Moreover, in the intervention group, the number of hospitalizations dropped from 0.7/person/year to 0.3/person/year (P=0.017), and emergency room visits dropped from 1.1 person/year to 0.2/person/year (P=0.002), while subjects in the control group did not experience any significant decreases in these parameters.CONCLUSIONS: A planned education program improved HRQoL while decreasing the number of emergency room visits and hospitalizations in patients with stable COPD; this improvement persisted at 12 months.


Author(s):  
Somayeh Ghadimi ◽  
Atefeh Fakharian ◽  
Mohsen Abedi ◽  
Reyhaneh Zahiri ◽  
Mahsan Norouz Afjeh ◽  
...  

Background: Chronic Obstructive Pulmonary Disease (COPD) leads to limited activity and reduced quality of life. Treatment of this disease is a long-term process that requires the cooperation of patients in monitoring and treatment. Methods: In the present study which was conducted from April 2019 to March 2021 in Masih Daneshvari Hospital, Tehran, Iran, 75 patients were randomly divided into telerehabilitation and control groups. Patients in the control group received pulmonary rehabilitation including respiratory, isometric, and aerobic exercises for 8 weeks, three times per week. In the second group, patients were given a lung rehabilitation booklet and asked to repeat the exercises three times a week for four weeks according to a specific schedule. In addition, patients installed Behzee care application on the mobile phone that recorded various indicators such as heart rate, SpO2, dyspnea, fatigue, and daily activities. This application reminded the patient of the program every day and at a specific time. Finally, the patients’ conditions were compared in the two groups after 8 weeks using CAT and mMRC questionnaires and 6-Minute Walk (6MW) exercise indices as well as spirometry tests. Results: In all four indicators (6MW, CAT,  and mMRC questionnaires as well as spirometry), patients showed improvement after rehabilitation (p<0.001). This improvement was significantly higher in the telemedicine group compared to the other group (p<0.01). Conclusion: The use of telerehabilitation in COPD patients is effective in improving spirometry indices, quality of life, as well as activity and sports indices.


2020 ◽  
Vol 74 (2) ◽  
pp. 91-94
Author(s):  
S.V. Turkina ◽  
◽  
A.A. Grishchenko ◽  
N.I. Zhernakova ◽  
T.Yu. Lebedev ◽  
...  

40 elderly and senile patients were examined including 20 patients with exacerbation of chronic obstructive pulmonary disease (COPD) of moderate severity (experimental group) and 20 cases without COPD, acute diseases and exacerbations of chronic pathology (control group). Impact of COPD was studied for various aspects of quality of life. It was analyzed the nature and strength of the relationship between of quality of life indicators and biochemical survey results.


2018 ◽  
Vol 1 (1) ◽  
Author(s):  
Mackenzie McGrath ◽  
Debra S. Burns ◽  
Shannon Crow ◽  
Aimee Lillie ◽  
Laura J. Myers ◽  
...  

Background  Chronic obstructive pulmonary disease (COPD) is highly prevalent among Veterans. Patients with COPD commonly experience dyspnea, which can be debilitating and may limit daily activities leading to a reduced quality of life. Pulmonary rehabilitation often includes teaching pursed lip breathing as a method to reduce dyspnea. However, patients with COPD, including Veterans, have limited access to pulmonary rehabilitation due to transportation constraints and lack of referrals by physicians.  Methods  MELodica Orchestra for DYspnea (MELODY) is a randomized controlled clinical trial designed to assess the safety, feasibility, and efficacy of a music-based approach to teach pursed lip breathing to Veterans with COPD experiencing dyspnea. Patients will be randomized in a 1:1:1 ratio to the intervention group, education only control group, and usual care control group using block randomization. Patients in the intervention group will meet twice weekly over twelve weeks for instruction on how to play the melodica and to participate in group music-making. The program also includes education about COPD, pursed lip breathing, tobacco cessation, and other relevant topics. Each participant will receive quantitative assessments (e.g., exercise endurance and dyspnea scales) and participate in qualitative interviews.   Anticipated Results  We expect the intervention to be safe and feasible. We hypothesize that patients in the intervention group will achieve the greatest reduction in dyspnea compared with patients in either control group.  Potential Impact  If pilot data demonstrates efficacy, then a multiple-site randomized control trial will be conducted with intent to introduce the program into routine clinical practice. 


2020 ◽  
Vol 4 (3) ◽  
Author(s):  
Lijun Chen ◽  
Wang Xu ◽  
Xiaoyong Ma ◽  
Xiuqin Ma ◽  
Yanhong Liu ◽  
...  

Objective: To evaluate the efficacy of transbronchoscopic large volume lung lavage in the treatment of pneumoconiosis complicated with chronic obstructive pulmonary disease (COPD). Methods: The clinical data of 80 patients with pneumoconiosis complicated with COPD admitted to our hospital from June 2017 to January 2019 were retrospectively analyzed. 40 patients in the control group were treated with conventional drugs and 40 patients in the observation group treated with conventional drugs plus transbronchoscopic large-volume lung lavage. Dyspnea score and healthy quality of life were compared between the two groups. Results: the scores of dyspnea in the observation group were significantly lower than those in the control group at 12, 24 and 48 weeks after treatment, and the (SGRQ) scores of George's respiratory problems questionnaire in the observation group were significantly lower than those in the control group at 12, 24 and 48 weeks after treatment. Conclusion: Thetransbronchoscopic large volume of lung lavage has a significant effect on the treatment of pneumoconiosis patients with COPD, which can effectively reduce the degree of dyspnea and improve the quality of life.


2020 ◽  
Vol 2 (1) ◽  
Author(s):  
Jun Xue ◽  
Yanan Zhang ◽  
Zhaohe Song ◽  
Lei Wang ◽  
Baoyin Bo

Aims:Objective to explore the influence of family enteral nutrition support on nutritional status, lung function, activity tolerance and quality of life in elderly patients with chronic obstructive pulmonary disease (COPD) in stable stage and malnutrition. Methods: a total of 165 elderly patients with COPD and malnutrition discharged from the geriatric department of our hospital were randomly divided into two groups: control group (82 cases) and observation group (83 cases). The control group was treated with conventional diet, and the observation group was treated with conventional diet + enteral nutrition suspension (nengjin, 500kcal / bottle, newdisia Pharmaceutical Co., Ltd.) for support. One month later, they were observed The body mass index (BMI), serum albumin (ALB), total protein (TP), hemoglobin (HB), pulmonary function of the two groups were observed: forced vital capacity (FVC), forced expiratory volume (FEV1) in the first second, FEV1 / FVC, FEV1% of the predicted value (FEV1%), exercise tolerance and quality of life.Results (1) compared with the control group, BMI and ALB in the observation group increased significantly (t = 10.465, 6.189, P < 0.05), TP and Hb had no significant change, and the difference was not statistically significant (t = 1.310, 1.302, P > 0.05). (2) compared with the control group, FVC, FEV1, FEV1 / FVC, FEV1% in the observation group increased, with statistical differences (t = 11.999, 19.654, 13.418, 16.924, P < 0.05). (3) compared with the control group, the quality of life symptom score, activity score, influence score and total score of the observation group decreased significantly (t = 15.303, 6.773, 23.600, 14.766, P < 0.05), and 6MWT increased significantly (t = 111.962, P < 0.05).Conclusion enteral nutrition support can improve the nutritional status, lung function, activity tolerance and quality of life of elderly patients with COPD in stable stage and malnutrition.


2019 ◽  
Vol 5 (2) ◽  
pp. 107-112
Author(s):  
Scholastica Fina Aryu Puspasari

Background: Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung illness with the main complaints of breathlessness and decreased activitiestolerance, which consequentially worsen the quality of life (QoL). COPD management aims to improve the QoLby means of rehabilitation programs. Objective: The study focused on determining the impact of physical activity(6-Minute Walk Test/6-MWT)and the combination of Pursed-Lip Breathing (PLB) before 6-MWTon COPD patients’QoL. Methods: This study occupieda quasi-experimentaldesign, which involved70 respondents,divided into 3 groups, i.e 2 intervention groups (30 respondents each) and one control group (10 respondents). Results:The majority of respondents were male (71%), aged 60-74 (56%), had normalBMI (48%), and were former smokers (59%).After 6 weeks of intervention, meaningful differences were found in the QoLbefore and after the intervention in bothgroups:6-MWT(p=0.000) and combined (p=0.000). The ordinal logistic regression test resultedthe combined intervention hadstronger effect on the quality of life (p=0.000, 47.1% contribution)than 6-MWT (p=0.012, 35.8% contribution). Respondents’ characteristics that impacted on the quality of life were smoking history and period of CPOD (p<0.05, OR: 11,376; OR: 49,75, respectively). Conclusion:It can be concluded that PLB before 6-MWT is an effective training to improve QoL of people with COPD. Keywords: Pursed-lip breathing; QoL;COPD


2016 ◽  
Vol 5 (2) ◽  
pp. 107-112
Author(s):  
Scholastica Fina Aryu Puspasari

Background: Chronic Obstructive Pulmonary Disease (COPD) is a progressive lung illness with the main complaints of breathlessness and decreased activitiestolerance, which consequentially worsen the quality of life (QoL). COPD management aims to improve the QoLby means of rehabilitation programs. Objective: The study focused on determining the impact of physical activity(6-Minute Walk Test/6-MWT)and the combination of Pursed-Lip Breathing (PLB) before 6-MWTon COPD patients’QoL. Methods: This study occupieda quasi-experimentaldesign, which involved70 respondents,divided into 3 groups, i.e. 2 intervention groups (30 respondents each) and one control group (10 respondents). Results:The majority of respondents were male (71%), aged 60-74 (56%), had normalBMI (48%), and were former smokers (59%).After 6 weeks of intervention, meaningful differences were found in the QoLbefore and after the intervention in bothgroups:6-MWT(p=0.000) and combined (p=0.000). The ordinal logistic regression test resultedthe combined intervention hadstronger effect on the quality of life (p=0.000, 47.1% contribution) than 6-MWT (p=0.012, 35.8% contribution). Respondents’ characteristics that impacted on the quality of life were smoking history and period of CPOD (p<0.05, OR: 11,376; OR: 49,75, respectively). Conclusion:It can be concluded that PLB before 6-MWT is an effective training to improve QoL of people with COPD. Keywords: pursed-lip breathing; QoL;COPD


Sign in / Sign up

Export Citation Format

Share Document