PT  - JOURNAL ARTICLE
AU  - Josefin Sundh
AU  - Scott Montgomery
AU  - Christer Janson
AU  - Eva Österlund Efraimsson
AU  - Björn Ställberg
AU  - Karin Lisspers
TI  - Can the organisation of COPD care in primary health care centres help preventing exacerbations in COPD patients?
DP  - 2012 Sep 01
TA  - European Respiratory Journal
PG  - 4337
VI  - 40
IP  - Suppl 56
4099  - http://erj.ersjournals.com/content/40/Suppl_56/4337.short
4100  - http://erj.ersjournals.com/content/40/Suppl_56/4337.full
SO  - Eur Respir J2012 Sep 01; 40
AB  - Introduction: COPD exacerbations are associated with lung function decline, lower quality of life and increased mortality, and can be prevented by pharmacological treatment and rehabilitation. The aim of this study was to explore if the organization of the COPD care in primary health care centres influences the risk for new exacerbations.Methods: A clinical population of 775 COPD patients was randomly selected from 70 Swedish primary health care centres (PHCCs). Data on COPD exacerbations and following preventive measures were obtained from medical record review. Cox regression analyses were used to estimate the risk of a new exacerbation with adjustment for age and sex.Results: During a study period of four years 458 patients had an exacerbation, and of these 278 patients (61%) had a second exacerbation during the follow-up period. Patients with a scheduled extra visit to an asthma/COPD nurse following an exacerbation had a decreased risk of a new exacerbation compared to patients with no extra follow-up besides regularly scheduled visits (adjusted hazard ratio (95% CI) 0.54 (0.32 to 0.93), p=0.026).Conclusion: Scheduling an extra visit to an asthma/COPD nurse following a COPD exacerbation decreased the risk of reexacerbations in primary care patients. We conclude that a close cooperation between professional categories is important in the prevention of COPD exacerbations in primary care.