Soins intégrés BPCO (Broncho-pneumopathie Chronique Obstructive) en Valais - Mieux Vivre Avec ma BPCO (COPD Integrated Care Program Valais - Living Well With COPD)

Summary

Background: Chronic obstructive pulmonary disease (COPD) is a progressive respiratory disorder characterized by acute exacerbations that contribute to physical impairment and increased healthcare use and costs. Given the increasing burden of this disease in terms of morbidity, disability, mortality and costs, innovative care models centered on patients and aiming at improving quality and comprehensiveness of care are needed. Effective implementation and evaluation of chronic disease management - integrated care(CDM-IC) programs, in the real world context is of great importance.

Aim of the pilot study: To conduct a pilot study assessing the acceptability, feasibility and effectiveness of a community-based CDM-IC program for COPD patients residing in the canton of Valais.

Design: The evaluation plan of this study will combine both quantitative (controlled before-after study design) and qualitative methods (focus groups with COPD patients and practicing healthcare professionals).

Setting: French-speaking part of the canton of Valais.

Patients: 50 adult (\>35 years) COPD patients GOLD stage I (symptomatic) - IV of the disease, non-institutionalized and residing in the canton of Valais. The control group of patients will be constituted of age and gender-matched COPD patients from the Swiss COPD cohort study.

Measures:

Quantitative part:

Primary outcomes: Generic and disease-specific health-related quality-of-life and all-cause hospitalizations (past 12 months)

Other outcomes:

1. Processes of care
2. Patients' assessment of how care is congruent with the Chronic Care Model (PACIC instrument)
3. Measure of self-efficacy (intermediary outcome)
4. 6-minutes walking test, nb of COPD exacerbations, % of current smokers
5. Healthcare utilization: unscheduled ambulatory care visits
6. Care satisfaction
7. Measures of the process of implementation of the intervention

Qualitative part: At 12 months: conduct of two focus groups of participating COPD patients, and of two focus groups of participating healthcare professionals.

Conditions

• Chronic Obstructive Pulmonary Disease (COPD)

Interventions

OTHER

COPD integrated care

The intervention will target COPD integrated care, and include a combination of patient-related, professional and organizational elements. It will be centered on patients' needs and focus on self-management education, proactive follow-up (scheduled visits and/or phone contacts), team work, healthcare professionals' training, promotion of pulmonary rehabilitation, physical activity and smoking cessation.

Sponsors & Collaborators

• University of Lausanne Hospitals

  collaborator OTHER

• Promotion santé Valais

  collaborator UNKNOWN

• Ligue pulmonaire valaisanne

  collaborator UNKNOWN

• Association des médecins de famille du Valais

  collaborator UNKNOWN

• Fondation Bangarter

  collaborator OTHER

• Swiss National Science Foundation

  collaborator OTHER

• Swiss School of Public Health (personal grant to Isabelle Peytremann-Bridevaux)

  collaborator UNKNOWN

• Centre Hospitalier du Centre du Valais

  lead OTHER

Principal Investigators

• Isabelle Peytremann-Bridevaux, MD, MPH, DSc · University of Lausanne Hospitals

• Bernard Burnand, MD, MPH · University of Lausanne Hospitals

• Jean-Marie Tschopp, MD · Centre Hospitalier du Centre du Valais

• Pierre-Olivier Bridevaux, MD, MSc · Centre Hospitalier du Centre du Valais

Study Design

Allocation

NON_RANDOMIZED

Purpose

HEALTH_SERVICES_RESEARCH

Masking

NONE

Model

PARALLEL

Eligibility

Min Age

35 Years

Sex

ALL

Healthy Volunteers

No

Timeline & Regulatory

Start

2013-03-31

Primary Completion

2015-08-31

Completion

2015-08-31

Countries

• Switzerland

Study Locations