TY - JOUR T1 - Program of Integrated Care for Patients with Chronic Obstructive Pulmonary Disease and Multiple Comorbidities (PIC COPD<sup>+</sup>): a randomised controlled trial JF - European Respiratory Journal JO - Eur Respir J DO - 10.1183/13993003.01567-2017 VL - 51 IS - 1 SP - 1701567 AU - Louise Rose AU - Laura Istanboulian AU - Lise Carriere AU - Anna Thomas AU - Han-Byul Lee AU - Shaghayegh Rezaie AU - Roshan Shafai AU - Ian Fraser Y1 - 2018/01/01 UR - http://erj.ersjournals.com/content/51/1/1701567.abstract N2 - We sought to evaluate the effectiveness of a multi-component, case manager-led exacerbation prevention/management model for reducing emergency department visits. Secondary outcomes included hospitalisation, mortality, health-related quality of life, chronic obstructive pulmonary disease (COPD) severity, COPD self-efficacy, anxiety and depression.Two-centre randomised controlled trial recruiting patients with ≥2 prognostically important COPD-associated comorbidities. We compared our multi-component intervention including individualised care/action plans and telephone consults (12-weekly then 9-monthly) with usual care (both groups). We used zero-inflated Poisson models to examine emergency department visits and hospitalisation; Cox proportional hazard model for mortality.We randomised 470 participants (236 intervention, 234 control). There were no differences in number of emergency department visits or hospital admissions between groups. We detected difference in emergency department visit risk, for those that visited the emergency department, favouring the intervention (RR 0.74, 95% CI 0.63–0.86). Similarly, risk of hospital admission was lower in the intervention group for those requiring hospital admission (RR 0.69, 95% CI 0.54–0.88). Fewer intervention patients died (21 versus 36) (HR 0.56, 95% CI 0.32–0.95). No differences were detected in other secondary outcomes.Our multi-component, case manager-led exacerbation prevention/management model resulted in no difference in emergency department visits, hospital admissions and other secondary outcomes. Estimated risk of death (intervention) was nearly half that of the control.Multicomponent, case manager-led intervention led to fewer ED and hospital admissions and almost halved risk of death http://ow.ly/J6Y730fM2GC ER -