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Early detection of COPD in general practice: patient or practice managed? A randomised controlled trial of two strategies in different socioeconomic environments
BACKGROUND: The burden of chronic obstructive pulmonary disease (COPD) is high. Health benefits can be gained in primary care by early detection and preventive measures. AIMS: To compare the effectiveness of two strategies for population-based early detection of COPD, taking into account different s...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Nature Publishing Group
2013
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442827/ https://www.ncbi.nlm.nih.gov/pubmed/23966214 http://dx.doi.org/10.4104/pcrj.2013.00070 |
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author | Dirven, Joseph AM Tange, Huibert J Muris, Jean WM van Haaren, Karin MA Vink, Gerrit van Schayck, Onno CP |
author_facet | Dirven, Joseph AM Tange, Huibert J Muris, Jean WM van Haaren, Karin MA Vink, Gerrit van Schayck, Onno CP |
author_sort | Dirven, Joseph AM |
collection | PubMed |
description | BACKGROUND: The burden of chronic obstructive pulmonary disease (COPD) is high. Health benefits can be gained in primary care by early detection and preventive measures. AIMS: To compare the effectiveness of two strategies for population-based early detection of COPD, taking into account different socioeconomic status (SES) settings. METHODS: Practices were randomised on strategy and stratified on SES setting. The Respiratory Health Screening Questionnaire (RHSQ) was distributed to all participants. In the practice-managed condition, the practice was responsible for the whole procedure, while in the patient-managed condition, patients were responsible for calculating their RHSQ risk score and applying for a spirometry test. The main outcome measure was the rate of COPD diagnoses after screening. RESULTS: More new COPD patients were detected in the practice-managed condition (36%) than in the patient-managed condition (18%). In low SES practices, more high-risk patients were found (16%) than in moderate-to-high SES practices (9%). Recalculated for a standard Dutch practice (2,350 patients), the yield would be 8.9 new COPD diagnoses, which is a 20% increase of known cases. CONCLUSIONS: The practice-managed variant of this screening procedure shows a substantial yield of new COPD diagnoses for both low and moderate-to-high SES practices. |
format | Online Article Text |
id | pubmed-6442827 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2013 |
publisher | Nature Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-64428272019-07-01 Early detection of COPD in general practice: patient or practice managed? A randomised controlled trial of two strategies in different socioeconomic environments Dirven, Joseph AM Tange, Huibert J Muris, Jean WM van Haaren, Karin MA Vink, Gerrit van Schayck, Onno CP Prim Care Respir J Research Paper BACKGROUND: The burden of chronic obstructive pulmonary disease (COPD) is high. Health benefits can be gained in primary care by early detection and preventive measures. AIMS: To compare the effectiveness of two strategies for population-based early detection of COPD, taking into account different socioeconomic status (SES) settings. METHODS: Practices were randomised on strategy and stratified on SES setting. The Respiratory Health Screening Questionnaire (RHSQ) was distributed to all participants. In the practice-managed condition, the practice was responsible for the whole procedure, while in the patient-managed condition, patients were responsible for calculating their RHSQ risk score and applying for a spirometry test. The main outcome measure was the rate of COPD diagnoses after screening. RESULTS: More new COPD patients were detected in the practice-managed condition (36%) than in the patient-managed condition (18%). In low SES practices, more high-risk patients were found (16%) than in moderate-to-high SES practices (9%). Recalculated for a standard Dutch practice (2,350 patients), the yield would be 8.9 new COPD diagnoses, which is a 20% increase of known cases. CONCLUSIONS: The practice-managed variant of this screening procedure shows a substantial yield of new COPD diagnoses for both low and moderate-to-high SES practices. Nature Publishing Group 2013-09 2013-08-21 /pmc/articles/PMC6442827/ /pubmed/23966214 http://dx.doi.org/10.4104/pcrj.2013.00070 Text en Copyright © 2013 Primary Care Respiratory Society UK |
spellingShingle | Research Paper Dirven, Joseph AM Tange, Huibert J Muris, Jean WM van Haaren, Karin MA Vink, Gerrit van Schayck, Onno CP Early detection of COPD in general practice: patient or practice managed? A randomised controlled trial of two strategies in different socioeconomic environments |
title | Early detection of COPD in general practice: patient or practice managed? A randomised controlled trial of two strategies in different socioeconomic environments |
title_full | Early detection of COPD in general practice: patient or practice managed? A randomised controlled trial of two strategies in different socioeconomic environments |
title_fullStr | Early detection of COPD in general practice: patient or practice managed? A randomised controlled trial of two strategies in different socioeconomic environments |
title_full_unstemmed | Early detection of COPD in general practice: patient or practice managed? A randomised controlled trial of two strategies in different socioeconomic environments |
title_short | Early detection of COPD in general practice: patient or practice managed? A randomised controlled trial of two strategies in different socioeconomic environments |
title_sort | early detection of copd in general practice: patient or practice managed? a randomised controlled trial of two strategies in different socioeconomic environments |
topic | Research Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6442827/ https://www.ncbi.nlm.nih.gov/pubmed/23966214 http://dx.doi.org/10.4104/pcrj.2013.00070 |
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