RT Journal Article
SR Electronic
T1 Care in Chronic Obstructive Lung Disease (CAROL): a randomised trial in general practice
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1701873
DO 10.1183/13993003.01873-2017
A1 Stefan Markun
A1 Thomas Rosemann
A1 Kaba Dalla-Lana
A1 Claudia Steurer-Stey
YR 2018
UL http://erj.ersjournals.com/content/early/2018/04/05/13993003.01873-2017.abstract
AB Background: Disease management of chronic obstructive pulmonary disease (COPD) is complex and shortcomings in general practice care for COPD are common. A care bundle is a disease management aid reminding and steering specific elements of care.Objectives: To test whether a COPD care bundle delivered to general practitioners (GPs) and practice assistants (PAs) increases the implementation of key elements of COPD care.Methods: Cluster-randomised clinical trial, 1:1 randomisation of GPs, one-year follow-up. The intervention introduced a COPD care bundle and aimed at enhancing collaboration between GPs and PAs. The control group continued usual care. The primary outcome measure was the composite score from nine key elements of COPD care measured at patient level.Results: We enrolled thirty-five GPs and 216 patients with a median age of 69 years, 59% female, 69% GOLD group A or B. After one year, the between-group difference in change of the primary outcome measure was +2.2 (95% CI +1.5 to +2.9) in favour of the intervention group. The intervention was associated with significantly higher implementation rates in 7 out of 9 key elements of care.Conclusion: Disease management using a COPD care bundle increased the implementation of key elements of COPD care in general practice.Disease management using a care bundle increases guideline adherence in general practice care for COPDFootnotesThis manuscript has recently been accepted for publication in the European Respiratory Journal. It is published here in its accepted form prior to copyediting and typesetting by our production team. After these production processes are complete and the authors have approved the resulting proofs, the article will move to the latest issue of the ERJ online. Please open or download the PDF to view this article.Conflict of interest: Dr. Markun reports grants from AstraZeneca Schweiz, grants from Boehringer Ingelheim Switzerland, grants from Department of Health of the Canton of Zurich, grants from Swiss Federal Office of Public Health (BAG), grants from Novartis Schweiz, during the conduct of the study.Conflict of interest: Dr. Rosemann reports grants from AstraZeneca Schweiz, grants from Boehringer Ingelheim Switzerland, grants from Department of Health of the Canton of Zurich, grants from Swiss Federal Office of Public Health (BAG), grants from Novartis Schweiz, during the conduct of the study.Conflict of interest: Dr. Dalla-Lana reports grants from AstraZeneca Schweiz, grants from Boehringer Ingelheim Switzerland, grants from Department of Health of the Canton of Zurich, grants from Swiss Federal Office of Public Health (BAG), grants from Novartis Schweiz, during the conduct of the study.Conflict of interest: Dr. Steurer-Stey reports grants from AstraZeneca Schweiz, grants from Boehringer Ingelheim Switzerland, grants from Department of Health of the Canton of Zurich, grants from Swiss Federal Office of Public Health (BAG), from Novartis Schweiz, during the conduct of the study.