Dataset Information

Application of a theoretical model to evaluate COPD disease management.

ABSTRACT:

Background

Disease management programmes are heterogeneous in nature and often lack a theoretical basis. An evaluation model has been developed in which theoretically driven inquiries link disease management interventions to outcomes. The aim of this study is to methodically evaluate the impact of a disease management programme for patients with chronic obstructive pulmonary disease (COPD) on process, intermediate and final outcomes of care in a general practice setting.

Methods

A quasi-experimental research was performed with 12-months follow-up of 189 COPD patients in primary care in the Netherlands. The programme included patient education, protocolised assessment and treatment of COPD, structural follow-up and coordination by practice nurses at 3, 6 and 12 months. Data on intermediate outcomes (knowledge, psychosocial mediators, self-efficacy and behaviour) and final outcomes (dyspnoea, quality of life, measured by the CRQ and CCQ, and patient experiences) were obtained from questionnaires and electronic registries.

Results

Implementation of the programme was associated with significant improvements in dyspnoea (p < 0.001) and patient experiences (p < 0.001). No significant improvement was found in mean quality of life scores. Improvements were found in several intermediate outcomes, including investment beliefs (p < 0.05), disease-specific knowledge (p < 0.01; p < 0.001) and medication compliance (p < 0.01). Overall, process improvement was established. The model showed associations between significantly improved intermediate outcomes and improvements in quality of life and dyspnoea.

Conclusions

The application of a theory-driven model enhances the design and evaluation of disease management programmes aimed at improving health outcomes. This study supports the notion that a theoretical approach strengthens the evaluation designs of complex interventions. Moreover, it provides prudent evidence that the implementation of COPD disease management programmes can positively influence outcomes of care.

SUBMITTER: Lemmens KM

PROVIDER: S-EPMC2859741 | biostudies-literature | 2010 Mar

REPOSITORIES: biostudies-literature

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Publications

Application of a theoretical model to evaluate COPD disease management.

Lemmens Karin M M KM Nieboer Anna P AP Rutten-Van Mölken Maureen P M H MP van Schayck Constant P CP Asin Javier D JD Dirven Jos A M JA Huijsman Robbert R

BMC health services research 20100326

<h4>Background</h4>Disease management programmes are heterogeneous in nature and often lack a theoretical basis. An evaluation model has been developed in which theoretically driven inquiries link disease management interventions to outcomes. The aim of this study is to methodically evaluate the impact of a disease management programme for patients with chronic obstructive pulmonary disease (COPD) on process, intermediate and final outcomes of care in a general practice setting.<h4>Methods</h4>A ...[more]

PMID: 20346135

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Dataset Information

Application of a theoretical model to evaluate COPD disease management.

Background

Methods

Results

Conclusions

Publications

Application of a theoretical model to evaluate COPD disease management.

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