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Favorable results from a Dutch asthma/COPD service for primary care

Esther Metting, Roland Riemersma, Robbert Sanderman, Thys van der Molen, Janwillem Kocks
European Respiratory Journal 2013 42: P277; DOI:
Esther Metting
1Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
3GRIAC Research Institute, Groningen, the Netherlands, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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Roland Riemersma
1Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
3GRIAC Research Institute, Groningen, the Netherlands, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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Robbert Sanderman
2Department of Health Sciences, Health Psychology Research, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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Thys van der Molen
1Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
3GRIAC Research Institute, Groningen, the Netherlands, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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Janwillem Kocks
1Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
3GRIAC Research Institute, Groningen, the Netherlands, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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Abstract

Introduction In 2007, an asthma/COPD(AC) service was implemented in The North of the Netherlands to advice general practitioner(GP)s in diagnosing and treating their asthma and COPD patients by involving local pulmonologists. GPs may refer patients for single/yearly follow up assessments. If so, patients are automatically scheduled for an additional 3 months assessment if a change in medication is advised by the pulmonologist. At the moment, ∼12.000 baseline and ∼1000 follow up visits are performed.

Aim To examine longitudinal data on disease related outcomes

Methods Spirometry, medical history, health status (Clinical COPD Questionnaire (CCQ)) and asthma control (Asthma Control Questionnaire (ACQ)) were assessed by the service. Non parametric tests were used for the evaluation of exacerbations and ACQ/CCQ scores between baseline and follow up.

Results The proportion of patients with ≥1 exacerbation/year decreased from 37% at baseline to 26% at 12 months (n=1062, p<0.000). In COPD patients scheduled for the 3 months follow up, the proportion of stable COPD patients (CCQ<1) increased from 37% (baseline) to 51% (3 months, n=149 p=0.001). In asthma patients the proportion of patients with well controlled asthma (ACQ <0.75) increased from 24% (baseline) to 49% (3 months, n=504 p<0.000).

Conclusion Patients in the AC service improved on exacerbation/year. If change in medication was advised, COPD patients improved on health status and asthma patients improved on asthma control. Asthma and COPD patients referred to 12 months follow up stabilized in health status and asthma control. More research is needed to elucidate which factors contribute to the improvement.

  • Primary care
  • COPD - management
  • Asthma - management
  • © 2013 ERS
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Favorable results from a Dutch asthma/COPD service for primary care
Esther Metting, Roland Riemersma, Robbert Sanderman, Thys van der Molen, Janwillem Kocks
European Respiratory Journal Sep 2013, 42 (Suppl 57) P277;

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Favorable results from a Dutch asthma/COPD service for primary care
Esther Metting, Roland Riemersma, Robbert Sanderman, Thys van der Molen, Janwillem Kocks
European Respiratory Journal Sep 2013, 42 (Suppl 57) P277;
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