title: Warm homes for older people: aims and methods of a randomised community-based trial for people with COPD.
abstract: BACKGROUND
  Chronic Obstructive Pulmonary Disease (COPD) is of increasing importance with about one in four people estimated to be diagnosed with COPD during their lifetime. None of the existing medications for COPD has been shown to have much effect on the long-term decline in lung function and there have been few recent pharmacotherapeutic advances. Identifying preventive interventions that can reduce the frequency and severity of exacerbations could have important public health benefits. The Warm Homes for Elder New Zealanders study is a community-based trial, designed to test whether a NZ$500 electricity voucher paid into the electricity account of older people with COPD, with the expressed aim of enabling them to keep their homes warm, results in reduced exacerbations and hospitalisation rates. It will also examine whether these subsidies are cost-beneficial.
  
  
  METHODS
  Participants had a clinician diagnosis of COPD and had either been hospitalised or taken steroids or antibiotics for COPD in the previous three years; their median age was 71 years. Participants were recruited from three communities between 2009 to early 2011. Where possible, participants' houses were retrofitted with insulation. After baseline data were received, participants were randomised to either 'early' or 'late' intervention groups. The intervention was a voucher of $500 directly credited to the participants' electricity company account. Early group participants received the voucher the first winter they were enrolled in the study, late participants during the second winter. Objective measures included spirometry and indoor temperatures and subjective measures included questions about participant health and wellbeing, heating, medication and visits to health professionals. Objective health care usage data included hospitalisation and primary care visits. Assessments of electricity use were obtained through electricity companies using unique customer numbers.
  
  
  CONCLUSIONS
  This community trial has successfully enrolled 522 older people with COPD. Baseline data showed that, despite having a chronic respiratory illness, participants are frequently cold in their houses and economise on heating.
  
  
  BACKGROUND
  The clinical trial registration is http://NCT01627418.
authors: He Kainga Oranga/Housing and Health Research Programme, University of Otago, PO Box 7343, Wellington, Wellington South, New Zealand. helen.viggers@otago.ac.nz
authors: Helen
authors: H
authors: Viggers
authors: Philippa
authors: P
authors: Howden-Chapman
authors: Tristram
authors: T
authors: Ingham
authors: Ralph
authors: R
authors: Chapman
authors: Gina
authors: G
authors: Pene
authors: Cheryl
authors: C
authors: Davies
authors: Ann
authors: A
authors: Currie
authors: Nevil
authors: N
authors: Pierse
authors: Helen
authors: H
authors: Wilson
authors: Jane
authors: J
authors: Zhang
authors: Michael
authors: M
authors: Baker
authors: Julian
authors: J
authors: Crane
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services / Q000191:economics / Q000379:methods*; D003362:Cost-Benefit Analysis; D004560:Electricity; D005260:Female; D006361:Heating / Q000191:economics; D006760:Hospitalization / Q000706:statistics & numerical data; D006798:Housing; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D015397:Program Evaluation; D029424:Pulmonary Disease, Chronic Obstructive / Q000517:prevention & control*; D012107:Research Design