Effects of Systematic Intervention for Chronic Obstructive Pulmonary Disease on Follow-up and Smoking Cessation Rates and Changes of the Pulmonary Function: A 7-year Longitudinal Study in a Japanese Rural City

OBJECTIVE: The early detection and treatment of chronic obstructive pulmonary disease (COPD) requires comprehensive follow-up over a long period. The aim of this study was to determine the effects of a comprehensive long-term intervention system developed by the COPD Task Force for a rural city in Japan during a 7-year period. METHODS: This prospective, community-based longitudinal study encompassed 2006-2013 in Matsuura City, Japan. Primary and secondary screenings were performed for the early diagnosis and treatment of COPD. Individuals diagnosed with COPD were managed by the COPD Task Force's comprehensive early intervention system. The outcomes of interest were the rate of continuous follow-up after the diagnosis of COPD, the smoking cessation rate, and changes in the pulmonary function during a 7-year period. SUBJECTS: The study included 8,878 residents of 50-89 years of age who resided in Matsuura in 2006. RESULTS: In total, 140 participants received definitive diagnoses of COPD in 2006. After 7 years of intervention, 34 patients withdrew; 78 (74%) patients continued with treatment in our intervention system. The rate of smoking cessation was significantly increased in the intervention group (from 30% to 68%; p<0.01) over the 7-year period. The change in forced expiratory volume in 1 second (FEV(1)) was -23.2 mL/year. CONCLUSION: Our systematic longitudinal intervention system during a 7-year period led to high rates of follow-up and smoking cessation. Furthermore, our system may be able to prevent the decline of FEV(1) in COPD patients. This intervention system may be effective in rural cities with few respiratory physicians.