Case Method Education on COPD to General Practitioners
- Conditions
- COPD
- Interventions
- Behavioral: Case method education in COPDBehavioral: Traditional education in COPD
- Registration Number
- NCT02213809
- Lead Sponsor
- Karolinska Institutet
- Brief Summary
Background:
COPD is an inflammatory and chronic obstructive lung disease, mainly caused by smoking. Most patients with COPD are discovered and treated in primary health care. Co-morbidity with heart disease, hypertension, diabetes, osteoporosis and underweight is common. It is important to diagnose COPD at an early stage, primarily to motivate smoking cessation, which is the most important factor for decelerating the progress of COPD. In addition, medication and rehabilitation to reduce symptoms of COPD can be given. Previous studies in Sweden have shown poor quality of primary health care provided to patients with COPD.
As general practitioners often deal with multiple medical problems and patients' motivation when diagnosing and treating COPD we hypothesize that case method education (see description under "intervention") in COPD has better effect than traditional education (see description under "intervention").This study aims to examine the effect of case method education on (1) learning in COPD among general practitioners and on (2) health in their patients with COPD.
Method:
Primary health care centers (PHCC) in Stockholm will be recruited. The PHCCs will be randomized to either case method education (n=9 PHCCs) or traditional education (n=9 PHCCs) in COPD for their general practitioners. The educations will be held during two times (two hours each) within a time range of three months, covering examination and treatment of patients with COPD. At least 10.000 patients should be listed at PHCCs included. Random sampling of 45 patients with COPD at stage 2-3 will be done from each PHCC. The patients will fill in a self-assessment questionnaire including CCQ, CAT and LINQ (see outcome measures) as well as questions about medication, exacerbations and other chronic diseases. The questionnaire will be sent to the patients 1-2 months before the education and 18 months after the education. Differences in assessments in the questionnaire before and after the education will be compared between the patients listed at the PHCCs that have received case method education vs. traditional education. In addition, general practitioners (approximately, n=180) at the PHCCs will fill in a questionnaire, immediately before and 12 months after the education, covering the learning outcomes in order to study differences in learning between the two intervention groups.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- COMPLETED
- Sex
- All
- Target Recruitment
- 822
- Primary Health Care Centers (PHCC): >10.000 patients listed. >70% permanent employed general practitioners
- Patients: Diagnosis of COPD registered at the COPD. Grade of COPD 2-3 (GOLD) at the latest spirometry completed since 2008.
- None
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Case method education in COPD Case method education in COPD Two hours of case method education in COPD are given two times within 3 months to the general practitioners at nine primary health care centers. The education covers examination, including interpretation av spirometry, and treatment of patients with COPD. The learning outcomes are predefined and are the same in both arms. The same person will teach at both times of education. Traditional education in COPD Traditional education in COPD Two hours of traditional education in COPD are given two times within 3 months to the general practitioners at nine primary health care centers.The education covers examination, including interpretation av spirometry, and treatment of patients with COPD. The learning outcomes are predefined and are the same in both arms. The same person will teach at both times of education.
- Primary Outcome Measures
Name Time Method Difference i patients' assessment of Clinical COPD Questionnaire (CCQ) before the intervention and 18 months later. 1-2 months before the intervention and 18 months after the intervention The CCQ measures health status in patients with COPD and consists of 10 items with an overall score and 3 domains: Symptoms (4 items), Functional state (4 items) and Mental state (2 items). All scores range from 0 to 6; (0 = no impairment).
Difference in questionnaire about knowledge in COPD (questionnaire created by the research group)among the general practitioners that receive the education. Immediately before the intervention and 12 months later. The questionnaire covers examination and treatment of COPD and includes multiple choice questions as well as questions about attitudes that will be answered in free text.
- Secondary Outcome Measures
Name Time Method Difference in patients' assessment of COPD Assessment Test (CAT) before the intervention and 18 months later. 1-2 months before the intervention and 18 months after the intervention The COPD Assessment Test (CAT) measures the impact of COPD on a person's life.
Difference i patients' assessment of Lung Information Needs Questionnaire (LINQ) before the intervention and 18 months later. 1-2 months before the intervention and 18 months after the intervention LINQ measures patients perceptions about COPD and what information about COPD patients think that they have percieved from health care personnel.
Trial Locations
- Locations (1)
Department of Family Medicine, NVS, Karolinska Institutet
🇸🇪Huddinge, Sweden