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Research News
May 21, 2008
Low Intensity Case Management Found Effective for COPD
A new study has found that low-intensity case management can benefit patients with chronic obstructive pulmonary disease (COPD) who are at high risk for hospitalization or emergency room visits. "While a model of intensive case management for COPD was previously shown to reduce hospitalizations for COPD, until now there has been little evidence that a more limited intervention model is effective," said Kathryn Rice, MD, staff physician in the Pulmonary Division of Minneapolis Veterans Affairs Hospital, who was recently asked to present her findings at the American Thoracic Society's (ATS) International Conference in Toronto. The ATS selected the study as an example of the focus and quality of the original research presented at the conference.
The multi-center study prospectively enrolled 743 patients at five VA Hospitals and randomized them to receive limited case-management or conventional care from their primary care provider. Those randomized to case management received an hour of clinical assessment and education in a group setting, personalized adjustment of their medications, a written action plan that included a description of COPD symptoms and exacerbations, specific medication instructions, as well as monthly follow-up calls from the case manager. Over the year of the study, emergency room visits for COPD decreased by more than one-half, and hospitalizations for COPD decreased by nearly one-third in the veterans who received limited case management versus those who received traditional treatment. Veterans in the limited case management group also showed improved measures in quality of life. "Because of its relative simplicity, we believe that this model could be easily implemented across a wide variety of clinical settings," said Dr. Rice.
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