title: Randomised controlled trial of home based care of patients with chronic obstructive pulmonary disease.
abstract: OBJECTIVE
  To evaluate usefulness of limited community based care for patients with chronic obstructive pulmonary disease after discharge from hospital.
  
  
  METHODS
  Randomised controlled trial.
  
  
  METHODS
  Liverpool Health Service and Macarthur Health Service in outer metropolitan Sydney between September 1999 and July 2000.
  
  
  METHODS
  177 patients randomised into an intervention group (84 patients) and a control group (93 patients) which received current usual care.
  
  
  METHODS
  Home visits by community nurse at one and four weeks after discharge and preventive general practitioner care.
  
  
  METHODS
  Frequency of patients' presentation and admission to hospital; changes in patients' disease-specific quality of life, measured with St George's respiratory questionnaire, over three months after discharge; patients' knowledge of illness, self management, and satisfaction with care at discharge and three months later; frequency of general practitioner and nurse visits and their satisfaction with care.
  
  
  RESULTS
  Intervention and control groups showed no differences in presentation or admission to hospital or in overall functional status. However, the intervention group improved their activity scores and the control group worsened their symptom scores. While intervention group patients received more visits from community nurses and were more satisfied with their care, involvement of general practitioners was much less (with only 31% (22) remembering receiving a care plan). Patients in the intervention group had higher knowledge scores and were more satisfied. There were no differences in general practitioner visits or management.
  
  
  CONCLUSIONS
  This brief intervention after acute care improved patients' knowledge and some aspects of quality of life. However, it failed to prevent presentation and readmission to hospital.
authors.affiliation: School of Community Medicine, University of New South Wales, Sydney 2052, Australia.
authors.forename: Oshana
authors.initials: O
authors.lastname: Hermiz
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Comino
authors.forename: Guy
authors.initials: G
authors.lastname: Marks
authors.forename: Kathy
authors.initials: K
authors.lastname: Daffurn
authors.forename: Stephen
authors.initials: S
authors.lastname: Wilson
authors.forename: Mark
authors.initials: M
authors.lastname: Harris
mesh_terms: D000328:Adult; D000359:Aftercare; D000368:Aged; D003152:Community Health Nursing / Q000458:organization & administration / Q000592:standards; D004739:England; D006699:Home Care Services / Q000458:organization & administration / Q000592:standards*; D006801:Humans; D008875:Middle Aged; D009517:New South Wales; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D029424:Pulmonary Disease, Chronic Obstructive / Q000451:nursing / Q000628:therapy*; D011788:Quality of Life