title: Effectiveness of the Assessment of Burden of COPD (ABC) tool on health-related quality of life in patients with COPD: a cluster randomised controlled trial in primary and hospital care.
abstract: Assessing the effectiveness of the Assessment of Burden of COPD (ABC) tool on disease-specific quality of life in patients with chronic obstructive pulmonary disease (COPD) measured with the St. George's Respiratory Questionnaire (SGRQ), compared with usual care.
  
  
  
  A pragmatic cluster randomised controlled trial, in 39 Dutch primary care practices and 17 hospitals, with 357 patients with COPD (postbronchodilator FEV1/FVC ratio <0.7) aged ≥40 years, who could understand and read the Dutch language. Healthcare providers were randomly assigned to the intervention or control group. The intervention group applied the ABC tool, which consists of a short validated questionnaire assessing the experienced burden of COPD, objective COPD parameter (eg, lung function) and a treatment algorithm including a visual display and treatment advice. The control group provided usual care. Researchers were blinded to group allocation during analyses. Primary outcome was the number of patients with a clinically relevant improvement in SGRQ score between baseline and 18-month follow-up. Secondary outcomes were the COPD Assessment Test (CAT) and the Patient Assessment of Chronic Illness Care (PACIC; a measurement of perceived quality of care).
  
  
  
  At 18-month follow-up, 34% of the 146 patients from 27 healthcare providers in the intervention group showed a clinically relevant improvement in the SGRQ, compared with 22% of the 148 patients from 29 healthcare providers in the control group (OR 1.85, 95% CI 1.08 to 3.16). No difference was found on the CAT (-0.26 points (scores ranging from 0 to 40); 95% CI -1.52 to 0.99). The PACIC showed a higher improvement in the intervention group (0.32 points (scores ranging from 1 to 5); 95% CI 0.14 to 0.50).
  
  
  
  This study showed that use of the ABC tool may increase quality of life and perceived quality of care.
  
  
  
  NTR3788; Results.
authors.affiliation: Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
authors.forename: Annerika H M
authors.initials: AH
authors.lastname: Slok
authors.affiliation: Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands Institute of General Practice, Medical Faculty of the Heinrich-Heine-University Düsseldorf, Düsseldorf, Germany.
authors.forename: Daniel
authors.initials: D
authors.lastname: Kotz
authors.affiliation: Department of Methodology & Statistics, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
authors.forename: Gerard
authors.initials: G
authors.lastname: van Breukelen
authors.affiliation: Department of Public Health and Primary Care, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: Niels H
authors.initials: NH
authors.lastname: Chavannes
authors.affiliation: Institute for Health Policy and Management/Institute for Medical Technology Assessment, Erasmus University Rotterdam, The Netherlands.
authors.forename: Maureen P M H
authors.initials: MP
authors.lastname: Rutten-van Mölken
authors.affiliation: Department of Pulmonary Diseases, Groningen Research Institute for Asthma and COPD (GRIAC), University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
authors.forename: Huib A M
authors.initials: HA
authors.lastname: Kerstjens
authors.affiliation: Department of General Practice, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
authors.forename: Thys
authors.initials: T
authors.lastname: van der Molen
authors.affiliation: Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands Foundation PICASSO for COPD, Alkmaar, The Netherlands.
authors.forename: Guus M
authors.initials: GM
authors.lastname: Asijee
authors.affiliation: Department of Pulmonary Diseases, Radboud University Medical Centre, Nijmegen, The Netherlands.
authors.forename: P N Richard
authors.initials: PN
authors.lastname: Dekhuijzen
authors.affiliation: Lung Foundation Netherlands, Amersfoort, The Netherlands.
authors.forename: Sebastiaan
authors.initials: S
authors.lastname: Holverda
authors.affiliation: Huisartsencoöperatie PreventZorg, Bilthoven, The Netherlands.
authors.forename: Philippe L
authors.initials: PL
authors.lastname: Salomé
authors.affiliation: Institute for Health Policy and Management/Institute for Medical Technology Assessment, Erasmus University Rotterdam, The Netherlands.
authors.forename: Lucas M A
authors.initials: LM
authors.lastname: Goossens
authors.affiliation: Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
authors.forename: Mascha
authors.initials: M
authors.lastname: Twellaar
authors.affiliation: Department of Pulmonology and SZT Centre of Excellence for Asthma & COPD, Sint Franciscus Vlietland Gasthuis, Rotterdam, The Netherlands.
authors.forename: Johannes C C M
authors.initials: JC
authors.lastname: In 't Veen
authors.affiliation: Department of Family Medicine, CAPHRI School for Public Health and Primary Care, Maastricht University, Maastricht, The Netherlands.
authors.forename: Onno C P
authors.initials: OC
authors.lastname: van Schayck
mesh_terms: D000368:Aged; D017281:Cost of Illness; D005260:Female; D006304:Health Status; D006760:Hospitalization; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D017060:Patient Satisfaction; D011320:Primary Health Care; D029424:Pulmonary Disease, Chronic Obstructive / Q000628:therapy; D011787:Quality of Health Care; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
keywords: Chronic Obstructive Pulmonary Disease; Communication tool; Disease Management; Patient-centred care; Quality of Life; Shared Decision Making