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

Research output: Contribution to journalArticleAcademicpeer-review

156 Downloads (Pure)

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