A cluster randomized trial of an interdisciplinary intervention for COPD in Australian primary care

Jenifer Liang, Michael Abramson, Nicholas Zwar, Grant Russell, Anne Holland, Billie Bonevski, Ajay Mahal, Kirsten Phillips, Paula Eustace, Eldho Paul, J George

Research output: Contribution to journalMeeting Abstractpeer-review

1 Citation (Scopus)

Abstract

Introduction
Interdisciplinary practice-based interventions could potentially benefit patients with COPD in primary care. We describe the RADICALS (Review of Airway Dysfunction and Interdisciplinary Community-based care of Adult Long-term Smokers) model of care delivered in Australian general practices.
Methods
General practices (n=43) were block-randomised into ICG (interdisciplinary care group) or UCG (usual care group). Patient participants with spirometry-confirmed COPD in UCG practices received routine care from their GP and Quitline referral, if appropriate. ICG participants received the RADICALS model of care, coordinated by a research assistant, GPs and staff at each clinic. The model comprised individualised smoking cessation support, a home medicines review (HMR) from a consultant pharmacist, and home-based pulmonary rehabilitation from specifically trained physiotherapists. The primary endpoint is change in Health Related Quality of Life (HRQoL), as measured by the St George's Respiratory Questionnaire (SGRQ), at 6 months from baseline. Other outcomes include changes in lung function, dyspnoea, COPD assessment test (CAT) score and EuroQol-5D at 6 and 12 months.
Results
A total of 275 patients with COPD were included – 161 in ICG and 114 in UCG. Their mean (±SD) age was 64.4 (±11.0) years; 171 (62%) were male and 168 (61%) were current smokers. Mean/median baseline SGRQ, CAT and mMRC scores were 32.3 (±18.2), 13.1 (±7.8) and 1 [IQR 0-2]. A total of 85 ICG participants received the HMR, 71 completed home-based pulmonary rehabilitation, and 62 received both components. Six month follow-ups are complete (n=208); 12 month follow-ups are in progress and will be completed by February 2018.
Conclusion
An interdisciplinary model of care for COPD has been developed, implemented and evaluated in general practice. HMR and home-based pulmonary rehabilitation had moderate acceptance as interventions by GPs and patients.
Original languageEnglish
Article numberTO 042
Pages (from-to)42-42
Number of pages1
JournalRespirology
Volume23
Issue numberS1
DOIs
Publication statusPublished - Mar 2018
Externally publishedYes

Keywords

  • COPD
  • primary health care
  • long-term smokers

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