GrippeCanadaV3, Main, Exploration, bibRecord, 000039

The Quebec Respiratory Health Education Network: Integrating a model of self-management education in COPD primary care.

Identifieur interne : 000039 ( Main/Exploration ); précédent : 000038; suivant : 000040

The Quebec Respiratory Health Education Network: Integrating a model of self-management education in COPD primary care.

Auteurs : Jean Bourbeau [Canada] ; Raquel Farias [Canada] ; Pei Zhi Li [Canada] ; Guylaine Gauthier [Canada] ; Livia Battisti [Canada] ; Valérie Chabot [Canada] ; Marie-France Beauchesne [Canada] ; Denis Villeneuve [Canada] ; Patricia Côté [Canada] ; Louis-Philippe Boulet [Canada]

Source :

Chronic respiratory disease [ 1479-9731 ] ; 2018.

RBID : pubmed:28750556

Descripteurs français

English descriptors

KwdEn :
- Adrenal Cortex Hormones (therapeutic use), Aged, Bronchodilator Agents (therapeutic use), Case Management, Emergency Service, Hospital (statistics & numerical data), Family Practice, Female, Health Knowledge, Attitudes, Practice, Health Status, Hospitalization (statistics & numerical data), Humans, Influenza Vaccines (therapeutic use), Male, Medication Adherence (statistics & numerical data), Middle Aged, Patient Education as Topic (methods), Patient Reported Outcome Measures, Primary Health Care, Pulmonary Disease, Chronic Obstructive (drug therapy), Pulmonary Disease, Chronic Obstructive (physiopathology), Quality of Life, Quebec, Self Care (methods), Spirometry.
MESH :
- chemical , therapeutic use : Adrenal Cortex Hormones, Bronchodilator Agents, Influenza Vaccines.
- geographic : Quebec.
- drug therapy : Pulmonary Disease, Chronic Obstructive.
- methods : Patient Education as Topic, Self Care.
- physiopathology : Pulmonary Disease, Chronic Obstructive.
- statistics & numerical data : Emergency Service, Hospital, Hospitalization, Medication Adherence.
- Aged, Case Management, Family Practice, Female, Health Knowledge, Attitudes, Practice, Health Status, Humans, Male, Middle Aged, Patient Reported Outcome Measures, Primary Health Care, Quality of Life, Spirometry.

Abstract

The objective of this study is to evaluate whether a chronic obstructive pulmonary disease (COPD) self-management education program with coaching of a case manager improves patient-related outcomes and leads to practice changes in primary care. COPD patients from six family medicine clinics (FMCs) participated in a 1-year educational program offered by trained case managers who focused on treatment adherence, inhaler techniques, smoking cessation, and the use of an action plan for exacerbations. Health-care utilization, health-related quality of life (HRQL), treatment adherence, inhaler technique, and COPD knowledge were assessed at each visit with validated questionnaires. We also evaluated whether the use of spirometry and the assessment of individual patient needs led to a more COPD-targeted treatment by primary care physicians, based on changes in prescriptions for COPD (medication, immunization, and written action plan). Fifty-four patients completed the follow-up visits and were included in the analysis. The number of unscheduled physician visits went from 40 the year before intervention to 17 after 1 year of educational intervention ( p = 0.033). Emergency room visits went from five to two and hospitalizations from two to three (NS). Significant improvements were observed in HRQL ( p = 0.0001), treatment adherence ( p = 0.025), adequate inhaler technique ( p < 0.0001), and COPD knowledge ( p < 0.001). Primary care physicians increased their prescriptions for long-acting bronchodilators with/without inhaled corticosteroid, flu immunizations, and COPD action plans in the event patient had an exacerbation. The COPD self-management educational intervention in FMCs reduced unscheduled visits to the clinic and improved patients' quality of life, self-management skills, and knowledge. The program had a positive impact on COPD-related practices by primary care physicians in the FMCs.

DOI: 10.1177/1479972317723237
PubMed: 28750556

Affiliations:

Canada

Links toward previous steps (curation, corpus...)

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Le document en format XML

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<front><div type="abstract" xml:lang="en">The objective of this study is to evaluate whether a chronic obstructive pulmonary disease (COPD) self-management education program with coaching of a case manager improves patient-related outcomes and leads to practice changes in primary care. COPD patients from six family medicine clinics (FMCs) participated in a 1-year educational program offered by trained case managers who focused on treatment adherence, inhaler techniques, smoking cessation, and the use of an action plan for exacerbations. Health-care utilization, health-related quality of life (HRQL), treatment adherence, inhaler technique, and COPD knowledge were assessed at each visit with validated questionnaires. We also evaluated whether the use of spirometry and the assessment of individual patient needs led to a more COPD-targeted treatment by primary care physicians, based on changes in prescriptions for COPD (medication, immunization, and written action plan). Fifty-four patients completed the follow-up visits and were included in the analysis. The number of unscheduled physician visits went from 40 the year before intervention to 17 after 1 year of educational intervention ( p = 0.033). Emergency room visits went from five to two and hospitalizations from two to three (NS). Significant improvements were observed in HRQL ( p = 0.0001), treatment adherence ( p = 0.025), adequate inhaler technique ( p < 0.0001), and COPD knowledge ( p < 0.001). Primary care physicians increased their prescriptions for long-acting bronchodilators with/without inhaled corticosteroid, flu immunizations, and COPD action plans in the event patient had an exacerbation. The COPD self-management educational intervention in FMCs reduced unscheduled visits to the clinic and improved patients' quality of life, self-management skills, and knowledge. The program had a positive impact on COPD-related practices by primary care physicians in the FMCs.</div>
</front>
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<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">28750556</PMID>
<DateCompleted><Year>2019</Year>
<Month>06</Month>
<Day>03</Day>
</DateCompleted>
<DateRevised><Year>2019</Year>
<Month>06</Month>
<Day>03</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1479-9731</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>15</Volume>
<Issue>2</Issue>
<PubDate><Year>2018</Year>
<Month>05</Month>
</PubDate>
</JournalIssue>
<Title>Chronic respiratory disease</Title>
<ISOAbbreviation>Chron Respir Dis</ISOAbbreviation>
</Journal>
<ArticleTitle>The Quebec Respiratory Health Education Network: Integrating a model of self-management education in COPD primary care.</ArticleTitle>
<Pagination><MedlinePgn>103-113</MedlinePgn>
</Pagination>
<ELocationID EIdType="doi" ValidYN="Y">10.1177/1479972317723237</ELocationID>
<Abstract><AbstractText>The objective of this study is to evaluate whether a chronic obstructive pulmonary disease (COPD) self-management education program with coaching of a case manager improves patient-related outcomes and leads to practice changes in primary care. COPD patients from six family medicine clinics (FMCs) participated in a 1-year educational program offered by trained case managers who focused on treatment adherence, inhaler techniques, smoking cessation, and the use of an action plan for exacerbations. Health-care utilization, health-related quality of life (HRQL), treatment adherence, inhaler technique, and COPD knowledge were assessed at each visit with validated questionnaires. We also evaluated whether the use of spirometry and the assessment of individual patient needs led to a more COPD-targeted treatment by primary care physicians, based on changes in prescriptions for COPD (medication, immunization, and written action plan). Fifty-four patients completed the follow-up visits and were included in the analysis. The number of unscheduled physician visits went from 40 the year before intervention to 17 after 1 year of educational intervention ( p = 0.033). Emergency room visits went from five to two and hospitalizations from two to three (NS). Significant improvements were observed in HRQL ( p = 0.0001), treatment adherence ( p = 0.025), adequate inhaler technique ( p < 0.0001), and COPD knowledge ( p < 0.001). Primary care physicians increased their prescriptions for long-acting bronchodilators with/without inhaled corticosteroid, flu immunizations, and COPD action plans in the event patient had an exacerbation. The COPD self-management educational intervention in FMCs reduced unscheduled visits to the clinic and improved patients' quality of life, self-management skills, and knowledge. The program had a positive impact on COPD-related practices by primary care physicians in the FMCs.</AbstractText>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Bourbeau</LastName>
<ForeName>Jean</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>1 Respiratory Epidemiology and Clinical Research Unit (RECRU), Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, Québec, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>2 Quebec Respiratory Health Education Network/Réseau Québécois d'Éducation en Santé Respiratoire (QRHEN/RQESR), Québec, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Farias</LastName>
<ForeName>Raquel</ForeName>
<Initials>R</Initials>
<AffiliationInfo><Affiliation>1 Respiratory Epidemiology and Clinical Research Unit (RECRU), Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, Québec, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Li</LastName>
<ForeName>Pei Zhi</ForeName>
<Initials>PZ</Initials>
<AffiliationInfo><Affiliation>1 Respiratory Epidemiology and Clinical Research Unit (RECRU), Research Institute of the McGill University Health Centre (RI-MUHC), Montreal, Québec, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Gauthier</LastName>
<ForeName>Guylaine</ForeName>
<Initials>G</Initials>
<AffiliationInfo><Affiliation>2 Quebec Respiratory Health Education Network/Réseau Québécois d'Éducation en Santé Respiratoire (QRHEN/RQESR), Québec, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Battisti</LastName>
<ForeName>Livia</ForeName>
<Initials>L</Initials>
<AffiliationInfo><Affiliation>2 Quebec Respiratory Health Education Network/Réseau Québécois d'Éducation en Santé Respiratoire (QRHEN/RQESR), Québec, Canada.</Affiliation>
</AffiliationInfo>
<AffiliationInfo><Affiliation>3 Hôpital St-François d'Assise, Québec, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Chabot</LastName>
<ForeName>Valérie</ForeName>
<Initials>V</Initials>
<AffiliationInfo><Affiliation>2 Quebec Respiratory Health Education Network/Réseau Québécois d'Éducation en Santé Respiratoire (QRHEN/RQESR), Québec, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Beauchesne</LastName>
<ForeName>Marie-France</ForeName>
<Initials>MF</Initials>
<AffiliationInfo><Affiliation>4 Centre Hospitalier Universitaire de Sherbrooke, Sherbrooke, Québec, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Villeneuve</LastName>
<ForeName>Denis</ForeName>
<Initials>D</Initials>
<AffiliationInfo><Affiliation>2 Quebec Respiratory Health Education Network/Réseau Québécois d'Éducation en Santé Respiratoire (QRHEN/RQESR), Québec, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Côté</LastName>
<ForeName>Patricia</ForeName>
<Initials>P</Initials>
<AffiliationInfo><Affiliation>2 Quebec Respiratory Health Education Network/Réseau Québécois d'Éducation en Santé Respiratoire (QRHEN/RQESR), Québec, Canada.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Boulet</LastName>
<ForeName>Louis-Philippe</ForeName>
<Initials>LP</Initials>
<AffiliationInfo><Affiliation>5 Institut Universitaire de Cardiologie et de Pneumologie de Québec, Université Laval, Québec, Canada.</Affiliation>
</AffiliationInfo>
</Author>
</AuthorList>
<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D013485">Research Support, Non-U.S. Gov't</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2017</Year>
<Month>07</Month>
<Day>27</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>England</Country>
<MedlineTA>Chron Respir Dis</MedlineTA>
<NlmUniqueID>101197408</NlmUniqueID>
<ISSNLinking>1479-9723</ISSNLinking>
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<ChemicalList><Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D000305">Adrenal Cortex Hormones</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D001993">Bronchodilator Agents</NameOfSubstance>
</Chemical>
<Chemical><RegistryNumber>0</RegistryNumber>
<NameOfSubstance UI="D007252">Influenza Vaccines</NameOfSubstance>
</Chemical>
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<MeshHeadingList><MeshHeading><DescriptorName UI="D000305" MajorTopicYN="N">Adrenal Cortex Hormones</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName>
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<MeshHeading><DescriptorName UI="D001993" MajorTopicYN="N">Bronchodilator Agents</DescriptorName>
<QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D019090" MajorTopicYN="Y">Case Management</DescriptorName>
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<MeshHeading><DescriptorName UI="D004636" MajorTopicYN="N">Emergency Service, Hospital</DescriptorName>
<QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName>
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<MeshHeading><DescriptorName UI="D005194" MajorTopicYN="N">Family Practice</DescriptorName>
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<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
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<MeshHeading><DescriptorName UI="D007722" MajorTopicYN="Y">Health Knowledge, Attitudes, Practice</DescriptorName>
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<MeshHeading><DescriptorName UI="D006304" MajorTopicYN="N">Health Status</DescriptorName>
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<MeshHeading><DescriptorName UI="D055118" MajorTopicYN="N">Medication Adherence</DescriptorName>
<QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D010353" MajorTopicYN="N">Patient Education as Topic</DescriptorName>
<QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000071066" MajorTopicYN="N">Patient Reported Outcome Measures</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011320" MajorTopicYN="Y">Primary Health Care</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D029424" MajorTopicYN="N">Pulmonary Disease, Chronic Obstructive</DescriptorName>
<QualifierName UI="Q000188" MajorTopicYN="Y">drug therapy</QualifierName>
<QualifierName UI="Q000503" MajorTopicYN="N">physiopathology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011788" MajorTopicYN="N">Quality of Life</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D011792" MajorTopicYN="N" Type="Geographic">Quebec</DescriptorName>
</MeshHeading>
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<MeshHeading><DescriptorName UI="D013147" MajorTopicYN="N">Spirometry</DescriptorName>
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</MeshHeadingList>
<KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">COPD</Keyword>
<Keyword MajorTopicYN="Y">COPD knowledge</Keyword>
<Keyword MajorTopicYN="Y">health-related quality of life</Keyword>
<Keyword MajorTopicYN="Y">inhaler technique</Keyword>
<Keyword MajorTopicYN="Y">self-management education</Keyword>
<Keyword MajorTopicYN="Y">treatment adherence</Keyword>
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<name sortKey="Battisti, Livia" sort="Battisti, Livia" uniqKey="Battisti L" first="Livia" last="Battisti">Livia Battisti</name>
<name sortKey="Battisti, Livia" sort="Battisti, Livia" uniqKey="Battisti L" first="Livia" last="Battisti">Livia Battisti</name>
<name sortKey="Beauchesne, Marie France" sort="Beauchesne, Marie France" uniqKey="Beauchesne M" first="Marie-France" last="Beauchesne">Marie-France Beauchesne</name>
<name sortKey="Boulet, Louis Philippe" sort="Boulet, Louis Philippe" uniqKey="Boulet L" first="Louis-Philippe" last="Boulet">Louis-Philippe Boulet</name>
<name sortKey="Bourbeau, Jean" sort="Bourbeau, Jean" uniqKey="Bourbeau J" first="Jean" last="Bourbeau">Jean Bourbeau</name>
<name sortKey="Chabot, Valerie" sort="Chabot, Valerie" uniqKey="Chabot V" first="Valérie" last="Chabot">Valérie Chabot</name>
<name sortKey="Cote, Patricia" sort="Cote, Patricia" uniqKey="Cote P" first="Patricia" last="Côté">Patricia Côté</name>
<name sortKey="Farias, Raquel" sort="Farias, Raquel" uniqKey="Farias R" first="Raquel" last="Farias">Raquel Farias</name>
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The Quebec Respiratory Health Education Network: Integrating a model of self-management education in COPD primary care.

The Quebec Respiratory Health Education Network: Integrating a model of self-management education in COPD primary care.

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