The clinical effectiveness of the COPDnet integrated care model

E. H. Koolen; B. van den Borst; M. de Man; J. C. Antons; B. Robberts; P. N. R. Dekhuijzen; J. H. Vercoulen; M. van den Heuvel; M. A. Spruit; P. J. van Der Wees; A. J. van't Hul

doi:10.1016/j.rmed.2020.106152

The clinical effectiveness of the COPDnet integrated care model

E. H. Koolen, B. van den Borst, M. de Man, J. C. Antons, B. Robberts, P. N. R. Dekhuijzen, J. H. Vercoulen, M. van den Heuvel, M. A. Spruit, P. J. van Der Wees, A. J. van't Hul^*

^*Corresponding author for this work

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

Rationale: Integrated care models have the potential to improve outcomes for patients with COPD. We therefore designed the COPDnet integrated care model and implemented it in two hospitals and affiliated primary care regions in the Netherlands. The COPDnet model consists of a comprehensive diagnostic trajectory ran in secondary care followed by a non-pharmacological intervention program of both monodisciplinary and multidisciplinary components.

Objective: To assess the clinical effectiveness of the COPDnet integrated care model on health status change in patients with COPD.

Methods: A total of 402 patients with COPD were offered care according to the COPDnet model. At baseline and between 7- and 9-months later health status was measured with the Clinical COPD Questionnaire (CCQ). Primary analysis was carried out for the sample at large. In addition, subgroup analyses were performed after stratification for the type of non-pharmacological intervention where patients had been referred to.

Results: The CCQ total score improved statistically significantly from 1.94 +/- 1.04 to 1.73 +/- 0.96 (P <0.01) in the 154 patients with valid follow-up measurements. Subgroup analyses revealed significant improvements in the patients receiving pulmonary rehabilitation only. No change in health status was found in patients receiving pharmacotherapy only, carried out self-treatment or who participated in mono-disciplinary primary care offered by allied healthcare professionals.

Conclusions: An improved health status was found in patients with COPD who received care according to the COPDnet integrated care model. Subgroups participating in an interdisciplinary pulmonary rehabilitation program predominantly accounted for this effect.

Original language	English
Article number	106152
Number of pages	8
Journal	Respiratory Medicine
Volume	172
DOIs	https://doi.org/10.1016/j.rmed.2020.106152
Publication status	Published - Oct 2020

Keywords

OBSTRUCTIVE PULMONARY-DISEASE
HEALTH-STATUS
ROUTINE CARE
REHABILITATION
IMPLEMENTATION
DELIVERY

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Cite this

@article{c53589eb6a544c13b3533cd3d4389d3d,

title = "The clinical effectiveness of the COPDnet integrated care model",

abstract = "Rationale: Integrated care models have the potential to improve outcomes for patients with COPD. We therefore designed the COPDnet integrated care model and implemented it in two hospitals and affiliated primary care regions in the Netherlands. The COPDnet model consists of a comprehensive diagnostic trajectory ran in secondary care followed by a non-pharmacological intervention program of both monodisciplinary and multidisciplinary components.Objective: To assess the clinical effectiveness of the COPDnet integrated care model on health status change in patients with COPD.Methods: A total of 402 patients with COPD were offered care according to the COPDnet model. At baseline and between 7- and 9-months later health status was measured with the Clinical COPD Questionnaire (CCQ). Primary analysis was carried out for the sample at large. In addition, subgroup analyses were performed after stratification for the type of non-pharmacological intervention where patients had been referred to.Results: The CCQ total score improved statistically significantly from 1.94 +/- 1.04 to 1.73 +/- 0.96 (P <0.01) in the 154 patients with valid follow-up measurements. Subgroup analyses revealed significant improvements in the patients receiving pulmonary rehabilitation only. No change in health status was found in patients receiving pharmacotherapy only, carried out self-treatment or who participated in mono-disciplinary primary care offered by allied healthcare professionals.Conclusions: An improved health status was found in patients with COPD who received care according to the COPDnet integrated care model. Subgroups participating in an interdisciplinary pulmonary rehabilitation program predominantly accounted for this effect.",

keywords = "OBSTRUCTIVE PULMONARY-DISEASE, HEALTH-STATUS, ROUTINE CARE, REHABILITATION, IMPLEMENTATION, DELIVERY",

author = "Koolen, {E. H.} and {van den Borst}, B. and {de Man}, M. and Antons, {J. C.} and B. Robberts and Dekhuijzen, {P. N. R.} and Vercoulen, {J. H.} and {van den Heuvel}, M. and Spruit, {M. A.} and {van Der Wees}, {P. J.} and {van't Hul}, {A. J.}",

note = "Funding Information: This study was made possible by a grant from foundation Picasso for COPD (reference number S18106). Unrestricted financial contributions to the development of the COPDnet model were gratefully received from AstraZeneca, Boehringer Ingelheim, Chiesi, GSK, Novartis and Teva. Publisher Copyright: {\textcopyright} 2020 Elsevier Ltd",

year = "2020",

month = oct,

doi = "10.1016/j.rmed.2020.106152",

language = "English",

volume = "172",

journal = "Respiratory Medicine",

issn = "0954-6111",

publisher = "Elsevier Saunders",

}

TY - JOUR

T1 - The clinical effectiveness of the COPDnet integrated care model

AU - Koolen, E. H.

AU - van den Borst, B.

AU - de Man, M.

AU - Antons, J. C.

AU - Robberts, B.

AU - Dekhuijzen, P. N. R.

AU - Vercoulen, J. H.

AU - van den Heuvel, M.

AU - Spruit, M. A.

AU - van Der Wees, P. J.

AU - van't Hul, A. J.

N1 - Funding Information: This study was made possible by a grant from foundation Picasso for COPD (reference number S18106). Unrestricted financial contributions to the development of the COPDnet model were gratefully received from AstraZeneca, Boehringer Ingelheim, Chiesi, GSK, Novartis and Teva. Publisher Copyright: © 2020 Elsevier Ltd

PY - 2020/10

Y1 - 2020/10

N2 - Rationale: Integrated care models have the potential to improve outcomes for patients with COPD. We therefore designed the COPDnet integrated care model and implemented it in two hospitals and affiliated primary care regions in the Netherlands. The COPDnet model consists of a comprehensive diagnostic trajectory ran in secondary care followed by a non-pharmacological intervention program of both monodisciplinary and multidisciplinary components.Objective: To assess the clinical effectiveness of the COPDnet integrated care model on health status change in patients with COPD.Methods: A total of 402 patients with COPD were offered care according to the COPDnet model. At baseline and between 7- and 9-months later health status was measured with the Clinical COPD Questionnaire (CCQ). Primary analysis was carried out for the sample at large. In addition, subgroup analyses were performed after stratification for the type of non-pharmacological intervention where patients had been referred to.Results: The CCQ total score improved statistically significantly from 1.94 +/- 1.04 to 1.73 +/- 0.96 (P <0.01) in the 154 patients with valid follow-up measurements. Subgroup analyses revealed significant improvements in the patients receiving pulmonary rehabilitation only. No change in health status was found in patients receiving pharmacotherapy only, carried out self-treatment or who participated in mono-disciplinary primary care offered by allied healthcare professionals.Conclusions: An improved health status was found in patients with COPD who received care according to the COPDnet integrated care model. Subgroups participating in an interdisciplinary pulmonary rehabilitation program predominantly accounted for this effect.

AB - Rationale: Integrated care models have the potential to improve outcomes for patients with COPD. We therefore designed the COPDnet integrated care model and implemented it in two hospitals and affiliated primary care regions in the Netherlands. The COPDnet model consists of a comprehensive diagnostic trajectory ran in secondary care followed by a non-pharmacological intervention program of both monodisciplinary and multidisciplinary components.Objective: To assess the clinical effectiveness of the COPDnet integrated care model on health status change in patients with COPD.Methods: A total of 402 patients with COPD were offered care according to the COPDnet model. At baseline and between 7- and 9-months later health status was measured with the Clinical COPD Questionnaire (CCQ). Primary analysis was carried out for the sample at large. In addition, subgroup analyses were performed after stratification for the type of non-pharmacological intervention where patients had been referred to.Results: The CCQ total score improved statistically significantly from 1.94 +/- 1.04 to 1.73 +/- 0.96 (P <0.01) in the 154 patients with valid follow-up measurements. Subgroup analyses revealed significant improvements in the patients receiving pulmonary rehabilitation only. No change in health status was found in patients receiving pharmacotherapy only, carried out self-treatment or who participated in mono-disciplinary primary care offered by allied healthcare professionals.Conclusions: An improved health status was found in patients with COPD who received care according to the COPDnet integrated care model. Subgroups participating in an interdisciplinary pulmonary rehabilitation program predominantly accounted for this effect.

KW - OBSTRUCTIVE PULMONARY-DISEASE

KW - HEALTH-STATUS

KW - ROUTINE CARE

KW - REHABILITATION

KW - IMPLEMENTATION

KW - DELIVERY

U2 - 10.1016/j.rmed.2020.106152

DO - 10.1016/j.rmed.2020.106152

M3 - Article

C2 - 32956973

SN - 0954-6111

VL - 172

JO - Respiratory Medicine

JF - Respiratory Medicine

M1 - 106152

ER -