title: Effect of health professional education on outcomes of chronic obstructive pulmonary disease in primary care: a non-randomized clinical trial.
abstract: OBJECTIVE
  The best strategy to achieve optimal integrated management to patients with chronic obstructive pulmonary disease (COPD) in primary care (PC) is not clear. We aimed to evaluate the effectiveness of an intervention in PC based on an integrated programme, which combines diverse strategies directed at health professionals to improve quality of life and clinical outcomes of their patients with COPD. We compared the outcome with results from standard practice.
  
  
  METHODS
  A prospective, multicentre, quasi-experimental study and a 12-month follow up was performed. Intervention consisted of an integrated education programme in PC. The main outcome variable was the change in total score of the St. George's Respiratory Questionnaire (SGRQ) at the end of follow up between the control and intervention group.
  
  
  RESULTS
  A total of 801 patients participated in the study with a mean age of 70.2 years and a mean FEV1 (% predicted) of 55%. At 1-year follow up, the SGRQ score did not significantly differ. Although the intervention group showed an improvement in dietary, exercise and smoking habits, there was an increase in reported exacerbations and hospital admissions (P < 0.001).
  
  
  CONCLUSIONS
  Implementation of an integrated education programme in a PC setting, which combines diverse strategies directed at health professionals, did not achieve the expected changes in quality of life measured by SGRQ at 1-year follow up. Nonetheless, this study observed an improvement in patients' lifestyle choices, even though this did not result in a significant change in the clinical evolution or heath status over 12 months.
authors: Research Department, IDIAP Jordi Gol, Barcelona, Spain. mmonteagudo@idiapjgol.org
authors: Mònica
authors: M
authors: Monteagudo
authors: Teresa
authors: T
authors: Rodriguez-Blanco
authors: Maria
authors: M
authors: Llagostera
authors: Carles
authors: C
authors: Valero
authors: Xavier
authors: X
authors: Bayona
authors: Sílvia
authors: S
authors: Granollers
authors: Juan J
authors: JJ
authors: Ferro
authors: Mateo
authors: M
authors: Acedo
authors: Jesús
authors: J
authors: Almeda
authors: Lluisa
authors: L
authors: Rodriguez-Latre
authors: Laura
authors: L
authors: Muñoz
authors: Marc
authors: M
authors: Miravitlles
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004517:Education, Professional; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D011320:Primary Health Care; D011379:Prognosis; D011446:Prospective Studies; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis* / Q000503:physiopathology; D011788:Quality of Life; D012129:Respiratory Function Tests