The effects of patient education in COPD in a 1-year follow-up randomised, controlled trial.
The aims were to explore the effects and health economic consequences of patient education in patients with COPD in a 12-month follow-up. Sixty-two patients with mild to moderate Chronic Obstructive Pulmonary Disease (COPD) were at our out-patient clinic randomly allocated to an intervention group or a control group. The intervention group participated in a 4h group patient education, followed by one to two individual nurse- and physiotherapist-sessions. Self-management was emphasised following a stepwise treatment plan. Effectiveness was expressed in terms of number of general practitioner (GP) consultations, proportions in need of GP consultations, utilisation of rescue medication and patient satisfaction. Costs related to doctor visits, days off work, dispensed pharmaceuticals, hospital admissions, travel costs, educational and time costs were recorded. Patient education reduced the need for GP visits with 85% (from 3.4 to 0.5, P<0.001) and kept a greater proportion independent of their GP during the 12-month follow-up, compared with no education (73% versus 15%, respectively). Patient education reduced the need for reliever medication from 290 to 125 Defined Daily Dosages (DDD), and improved patient satisfaction with overall handling of their disease at GP. The control and intervention groups induced mean total costs of NOK 19,900 and 10,600 per patient, respectively. For every NOK put into patient education, there was a saving of 4.8. The Number Needed to Educate (NNE) to make one person satisfied with their GP was 4.5 and associated with a concomitant saving of NOK 41,900. Patient education of patients with COPD improved patient outcomes and reduced costs in a 12-month follow-up.
Section of Pulmonary Medicine, Medical Department, Vest-Agder Hospital, Kristiansand, Norway. frode.gallefoss@vas.no
Frode
F
Gallefoss
D003362:Cost-Benefit Analysis; D005260:Female; D005500:Follow-Up Studies; D015438:Health Behavior; D017048:Health Care Costs; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D008875:Middle Aged; D009664:Norway; D010353:Patient Education as Topic / Q000191:economics; D017060:Patient Satisfaction; D015397:Program Evaluation; D029424:Pulmonary Disease, Chronic Obstructive / Q000191:economics / Q000517:prevention & control* / Q000523:psychology; D012017:Referral and Consultation; D012648:Self Care / Q000191:economics; D016896:Treatment Outcome