Effectiveness of the Assessment of Burden of COPD (ABC) tool on health-related quality of life in patients with COPD: a cluster randomised controlled trial in primary and hospital care

Annerika H. M. Slok, Daniel Kotz, Gerard van Breukelen, Niels H Chavannes, Maureen P M H Rutten-van Mölken, Huib A M Kerstjens, Thys van der Molen, Guus M Asijee, P N Richard Dekhuijzen, Sebastiaan Holverda, Philippe L Salomé, Lucas M A Goossens, Mascha Twellaar, Johannes C C M In 't Veen, Onno C.P. van Schayck

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Abstract

OBJECTIVE: Assessing 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) measured with the St. George's Respiratory Questionnaire (SGRQ), compared with usual care.

METHODS: A pragmatic cluster randomised controlled trial, in 39 Dutch primary care practices and 17 hospitals, with 357 patients with COPD (postbronchodilator FEV1/FVC ratio <0.7) aged ≥40 years, who could understand and read the Dutch language. Healthcare providers were randomly assigned to the intervention or control group. The intervention group applied the ABC tool, which consists of a short validated questionnaire assessing the experienced burden of COPD, objective COPD parameter (eg, lung function) and a treatment algorithm including a visual display and treatment advice. The control group provided usual care. Researchers were blinded to group allocation during analyses. Primary outcome was the number of patients with a clinically relevant improvement in SGRQ score between baseline and 18-month follow-up. Secondary outcomes were the COPD Assessment Test (CAT) and the Patient Assessment of Chronic Illness Care (PACIC; a measurement of perceived quality of care).

RESULTS: At 18-month follow-up, 34% of the 146 patients from 27 healthcare providers in the intervention group showed a clinically relevant improvement in the SGRQ, compared with 22% of the 148 patients from 29 healthcare providers in the control group (OR 1.85, 95% CI 1.08 to 3.16). No difference was found on the CAT (-0.26 points (scores ranging from 0 to 40); 95% CI -1.52 to 0.99). The PACIC showed a higher improvement in the intervention group (0.32 points (scores ranging from 1 to 5); 95% CI 0.14 to 0.50).

CONCLUSIONS: This study showed that use of the ABC tool may increase quality of life and perceived quality of care.

TRIAL REGISTRATION NUMBER: NTR3788; Results.

Original languageEnglish
Article numbere011519
Number of pages12
JournalBMJ Open
Volume6
Issue number7
DOIs
Publication statusPublished - 2016

Keywords

  • OBSTRUCTIVE PULMONARY-DISEASE
  • SHARED DECISION-MAKING
  • ASSESSMENT TEST CAT
  • GEORGES RESPIRATORY QUESTIONNAIRE
  • SELF-MANAGEMENT
  • CLINICAL-TRIALS
  • CHRONIC ILLNESS
  • BASE-LINE
  • MODEL
  • TIOTROPIUM

Cite this

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., & van Schayck, O. C. P. (2016). Effectiveness of the Assessment of Burden of COPD (ABC) tool on health-related quality of life in patients with COPD: a cluster randomised controlled trial in primary and hospital care. BMJ Open, 6(7), [e011519]. https://doi.org/10.1136/bmjopen-2016-011519