"Consultation Liaison and Integrated Care for COPD Patients With Psychiatric Co-Morbidity"

Summary

Chronic obstructive pulmonary disease (COPD) stands out among chronic diseases with its high and rising prevalence and mortality, poor quality of life, high re-hospitalization rates and societal burden of care. Current therapeutic and management practices are generally met with limited success. Research in recent years have highlighted the high level of psychiatric co-morbidity in COPD patients, and the major prognostic significance of anxiety/depression in COPD outcomes such as re-hospitalization, smoking cessation, quality of life, and survival. This suggests that addressing psychiatric and psycho-social aspects of care prominent in COPD patients may have strongly positive impact on outcomes, but the available evidence of effectiveness is limited.

The primary aim of the proposed research is to evaluate the effectiveness of a holistic disease management paradigm of psychiatric liaison consultation (CL) that integrates psychiatric and respiratory care to improve outcomes for COPD patients. This integrated psychiatric consultation liaison (IPCL) management paradigm includes the routine screening and structured collaborative care of anxiety and major depressive symptoms and depressive/anxiety disorder in COPD patients. We postulate that the IPCL care paradigm would reduce mood symptoms, increase smoking quit rates, reduce symptom burden and functional disability, and improve quality of life, while reducing rehospitalization, emergency department (ED) and unscheduled physician visits. A secondary aim is to evaluate its cost effectiveness by concurrently collecting resource utilization data.

Conditions

• Chronic Obstructive Pulmonary Disease
• Anxiety
• Depression

Interventions

PROCEDURE

Integrated care

Integrated care will be provided with management of multifaceted group including, nurse educators, doctors, case manager and psychologists.

PROCEDURE

Usual control

Usual control group will be provided with usual standard procedures for management of COPD and psychiatric comorbidities.

Sponsors & Collaborators

• National University Hospital, Singapore

  collaborator OTHER

• Singapore General Hospital

  collaborator OTHER

• Alexandra Hospital

  collaborator OTHER

• St Luke's Hospital, Singapore

  collaborator OTHER

• Changi General Hospital

  collaborator OTHER

• National University of Singapore

  lead OTHER

Principal Investigators

• Ng T Pin, MD · National University of Singapore

Study Design

Allocation

RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

SINGLE

Model

PARALLEL

Eligibility

Min Age

55 Years

Max Age

90 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2012-08-31

Primary Completion

2017-12-31

Completion

2017-12-31

Countries

• Singapore

Study Locations