The effects of additional care by a pulmonary nurse for asthma and COPD patients at a respiratory outpatient clinic: results from a double blind, randomized clinical trial.
OBJECTIVE
To assess the effects of additional information based nursing care program in the treatment of asthma and COPD patients at a pulmonary outpatient clinic.


METHODS
In a double blind, randomized clinical trial, 191 patients were allocated to an additional care group or control group. Patients in the intervention group received a protocol-based education program on individual basis by a pulmonary nurse on individual basis (average duration 60 min per patient). All patients were masked for the trial objectives. Effectiveness was expressed in terms of knowledge, inhalation technique, self-management, exacerbation rate (primary outcomes), and health-related quality of life and satisfaction with care received (secondary outcomes). The time interval between the initial and final assessments was 6 months.


RESULTS
Ninety-seven patients were randomized into the additional care group and 94 into the control group, of which 157 had a complete dataset. (Un)adjusted analyses did not show differences between treatment groups in terms of knowledge, inhalation technique, self-management, health-related quality of life, and satisfaction with care. Multivariate logistic regression adjusting for baseline covariates showed a significant treatment effect with regard to exacerbation rate (odds ratio=0.35; 95% confidence limits: 0.13/0.94, p=0.04).


CONCLUSIONS
With the exception of exacerbation rate, we could not demonstrate efficacy of additional nursing care in a broad range of outcome parameters.


CONCLUSIONS
At present we do not recommend to implement our patient-tailored education program in daily practice.
Rootmensen
Geert N
GN
Department of Pulmonology, Academic Medical Centre, Amsterdam, The Netherlands. geert_rootmensen@yahoo.com
van Keimpema
Anton R J
AR
Looysen
Elske E
EE
van der Schaaf
Letty
L
de Haan
Rob J
RJ
Jansen
Henk M
HM
D000553:Ambulatory Care / Q000458:organization & administration* / Q000523:psychology; D001249:Asthma / Q000451:nursing* / Q000523:psychology; D004311:Double-Blind Method; D004521:Educational Measurement; D005260:Female; D005541:Forced Expiratory Volume; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009426:Netherlands; D009720:Nurse Clinicians / Q000458:organization & administration*; D015403:Nursing Evaluation Research; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic / Q000458:organization & administration*; D017060:Patient Satisfaction; D029424:Pulmonary Disease, Chronic Obstructive / Q000451:nursing* / Q000523:psychology; D011788:Quality of Life / Q000523:psychology; D012648:Self Care / Q000523:psychology; D011795:Surveys and Questionnaires