Document Detail


The effect of a respiratory home nurse intervention in patients with chronic obstructive pulmonary disease (COPD).
MedLine Citation:
PMID:  10630654     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Chronic obstructive pulmomary disease (COPD) is associated with substantial mortality, morbidity, and costs to the health care system. With the increasing interest in outreach care programmes it is important to evaluate their impact upon patients and health services, for conditions such as COPD. AIM: To determine the effectiveness of an outreach respiratory nurse in a shared care approach, with collaboration between general practitioners and hospital services, in the management of patients with severe COPD. METHODS: Patients with severe COPD attending The Queen Elizabeth Hospital, Adelaide participated in a randomised controlled trial of a home based nursing intervention (HBNI) over 12 months with outcome measures including mortality rate, hospital service utilisation, FEV1 and health related quality of life (HRQL) using a modified Dartmouth Primary Care Co-operative Quality of Life questionnaire. RESULTS: There were 48 subjects in each study arm, with no differences in mortality rate (eight deaths in the HBNI group and seven in the control group), hospital admissions, length of stay, number of outpatient and Emergency Service visits. The study had inadequate follow-up of FEV1 and HRQL within the control group. Within the HBNI group, a small improvement in HRQL (in three of ten indices measured) was demonstrated, despite a deterioration in FEV1 (11% reduction, p=0.04) compared to baseline. Quality of life of HBNI subjects' carers did not change. CONCLUSION: An increased level of care given by an outreach respiratory nurse in a shared care approach for patients with severe COPD produced small improvements in HRQL but did not result in the prevention of deaths or reduced health care utilisation.
Authors:
B J Smith; S L Appleton; P W Bennett; G C Roberts; P Del Fante; R Adams; C M Trott; D P Allan; A M Southcott; R E Ruffin
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Australian and New Zealand journal of medicine     Volume:  29     ISSN:  0004-8291     ISO Abbreviation:  Aust N Z J Med     Publication Date:  1999 Oct 
Date Detail:
Created Date:  2000-02-03     Completed Date:  2000-02-03     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  1264322     Medline TA:  Aust N Z J Med     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  718-25     Citation Subset:  IM    
Affiliation:
Department of Medicine, University of Adelaide, SA. BSMITH@tqehsmtp.tqeh.sa.gov.au
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MeSH Terms
Descriptor/Qualifier:
Aged
Female
Health Services / utilization
Home Care Services*
Hospitalization / statistics & numerical data
Humans
Lung Diseases, Obstructive / mortality,  nursing*
Male
Quality of Life
Respiratory Mechanics

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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