Patient self-management in primary care patients with mild COPD – protocol of a randomised controlled trial of telephone health coaching
Patient self-management in primary care patients with mild COPD – protocol of a randomised controlled trial of telephone health coaching
复制标题
轻度慢性阻塞性肺病初级保健患者的患者自我管理——电话健康辅导随机对照试验方案
作者：
M. Sidhu;A. Daley;R. Jordan;P. Coventry;C. Heneghan;S. Jowett;Sally J. Singh;J. Marsh;P. Adab;J. Varghese;D. Nunan;A. Blakemore;J. Stevens;L. Dowson;D. Fitzmaurice;K. Jolly
背景在英国，确诊的慢性阻塞性肺疾病（COPD）的患病率为1.8%，尽管据估计，这占人口总数的不到一半，因为仍有许多未确诊的疾病。初级保健中的病例发现倡议将确定患有轻度疾病和症状的人。大多数自我管理试验已经确定了来自二级护理诊所或因病情恶化而入院的患者。这项试验将招募一个有轻度COPD症状的初级保健人群，并使用电话健康指导来鼓励自我管理。方法/设计在这项研究中，使用多中心随机对照试验（RCT），在英格兰至少有70个一般实践，我们计划建立护士主导的电话健康指导的有效性，与常规护理相比，初级护理中仅报告轻度COPD症状（MRC 1级和2级）的患者的管理。干预措施的重点是接受戒烟服务，增加身体活动，药物管理和行动计划，并以行为改变理论为基础。我们的目标是招募556例经肺量测定确诊的COPD患者，并在6个月和12个月时进行随访。主要结局是使用圣乔治呼吸问卷（SGRQ）评估的健康相关生活质量。在基线时测量肺活量和BMI。次要结果包括自我报告的健康行为（吸烟和身体活动），通过加速度计测量的身体活动（12个月），心理发病率，自我效能和干预的成本效益。纵向定性访谈将探讨参与者如何参与干预和嵌入式行为改变是在每天的practices.DiscussionThis试验将提供有力的证据，一种新的电话健康指导干预的有效性，以促进行为改变和预防疾病进展的患者在初级保健呼吸困难的轻度症状。
BackgroundThe prevalence of diagnosed chronic obstructive pulmonary disease (COPD) in the UK is 1.8%, although it is estimated that this represents less than half of the total disease in the population as much remains undiagnosed. Case finding initiatives in primary care will identify people with mild disease and symptoms. The majority of self-management trials have identified patients from secondary care clinics or following a hospital admission for exacerbation of their condition. This trial will recruit a primary care population with mild symptoms of COPD and use telephone health coaching to encourage self-management.Methods/DesignIn this study, using a multi-centred randomised controlled trial (RCT) across at least 70 general practices in England, we plan to establish the effectiveness of nurse-led telephone health coaching to support self-management in primary care for people who report only mild symptoms of their COPD (MRC grade 1 and 2) compared to usual care. The intervention focuses on taking up smoking cessation services, increasing physical activity, medication management and action planning and is underpinned by behavioural change theory. In total, we aim to recruit 556 patients with COPD confirmed by spirometry with follow up at six and 12 months. The primary outcome is health related quality of life using the St Georges Respiratory Questionnaire (SGRQ). Spirometry and BMI are measured at baseline. Secondary outcomes include self-reported health behaviours (smoking and physical activity), physical activity measured by accelerometery (at 12 months), psychological morbidity, self-efficacy and cost-effectiveness of the intervention. Longitudinal qualitative interviews will explore how engaged participants were with the intervention and how embedded behaviour change was in every day practices.DiscussionThis trial will provide robust evidence about the effectiveness of a novel telephone health coaching intervention to promote behaviour change and prevent disease progression in patients with mild symptoms of dyspnoea in primary care.Trial registrationCurrent controlled trials ISRCTN06710391.
DOI：
10.1164/rccm.200204-318oc
发表时间：
2003-03-15
影响因子：
24.7
作者：
Ries, AL;Kaplan, RM;Prewitt, LM
通讯作者：
Prewitt, LM