The feasibility of a primary care model for the management of COPD.
OBJECTIVE
To investigate the feasibility of a primary care model to improve the management of COPD.


METHODS
An intervention study on 1,497 patients with documented COPD from 22 general practices, involving 11 practice nurses and a COPD Support Service (CSS). Outcome measures included the successful delegation of tasks from general practitioners (GPs) to the CSS and practice nurse, and performance in daily practice according to the model components -- keeping a patient register with a recall system, periodical history taking and lung function measurements, asking diagnostic and therapeutic advice, and performing regular follow-up visits with education and counselling.


RESULTS
In the 22 general practices, all components of the model were performed systematically, with the exception of 'asking for diagnostic and therapeutic advice' which occurred in 10 practices only. Of the 1,497 patients, 374 (25%) were treated by chest physicians. Of the remaining patients 88% were included in the primary care model and 12% refused regular follow-up.


CONCLUSIONS
This primary care model for COPD management proved to be very feasible; GPs delegated the tasks, almost all patients were included in the control system, and a large majority of patients accepted follow-up according to the model.
Meulepas
Marianne A
MA
Centre for Quality of Care Research (WOK), University Medical Centre, 6500 HB Nijmegen, The Netherlands. m.meulepas@kwazo.umcn.nl
Jacobs
Johanna E
JE
Lucas
Annelies E M
AE
Smeenk
Frank W J M
FW
Smeele
Ivo
I
Bottema
Ben J A M
BJ
Grol
Richard P T M
RP
D005194:Family Practice / Q000592:standards*; D005240:Feasibility Studies; D005260:Female; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017063:Outcome Assessment, Health Care; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care / Q000379:methods*; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy*; D015272:Pulmonary Medicine / Q000592:standards; D012042:Registries