TY - JOUR T1 - A 2 year follow up randomized pilot study of a care on demand system in COPD patients JF - European Respiratory Journal JO - Eur Respir J VL - 42 IS - Suppl 57 SP - P1375 AU - Farida Berkhof AU - Anne Hesselink AU - Steven Uil AU - Huib Kerstjens AU - Jan Willem van den Berg Y1 - 2013/09/01 UR - http://erj.ersjournals.com/content/42/Suppl_57/P1375.abstract N2 - Introduction Traditionally, outpatient visits for chronic pulmonary disease (COPD) are fixed appointments pre-planned by the pulmonologist. This pilot study determined the effect of an on-demand-system, patient initiated outpatient visits, on health status and COPD-related health care resource use (HCRU).Methods 100 patients were randomized between on-demand or usual care. To assess health status during 2 years the Clinical COPD Questionnaire (CCQ), the St. George’s Respiratory Questionnaire (SGRQ) and Short Form-36 (SF-36) were used. To evaluate HCRU, visits to general practitioners (GP), pulmonologists, and pulmonary nurse practitioners (PNP) and exacerbations were counted.Results Baseline characteristics were similar in both groups. COPD-specific health status (CCQ, primary outcome) deteriorated in both groups, slightly but not significantly less in the on-demand-group. The CCQ symptom domain did show a significant and clinically relevant difference in favour of the on-demand group, -0.4±0.21, CI95% -0.87;-0.02, p=0.04. A similar tendency was found for SGRQ. Results for SF-36 were inconsistent and not significant. Patients in the on-demand-group visited the GP significantly less (p=0.01), but the PNP significantly more frequently, p=0.003. Visits to pulmonologists and exacerbations were equally frequent in both groups.Conclusion This pilot study found that the results of the on-demand-system were comparable with usual care and can be instituted with confidence in the COPD outpatient care setting. ER -