A Comprehensive Care Programme for Patients With Chronic Obstructive Pulmonary Disease
A Comprehensive Care Programme for Patients With Chronic Obstructive Pulmonary Disease
Objective: Chronic obstructive pulmonary disease (COPD) is a disease with significant
 morbidity and incurs heavy utilization of healthcare resources. The direct cost of hospital
 admissions related to COPD is the single largest source of expenditure in the public hospital
 system. This study aims to assess whether a comprehensive care programme can decrease the
 rate of hospital admissions for COPD patients.
Design: A randomised controlled trial of patients discharged from hospital after an episode
 of acute exacerbation of COPD. Patients will be randomised to the intervention arm or usual
 care group.

 Setting: Tertiary University affiliated Hospital.

 Interventions:

 The Intervention group will receive a comprehensive programme which involves inputs from
 doctors, respiratory nurses and physiotherapists, providing an individualized care plan for
 each subject. The components in the programme will include optimization of medications,
 specialist physician follow up, nursing support in education, and physiotherapist support for
 pulmonary rehabilitation. Patients in the intervention group will also receive monthly
 telephone calls by a respiratory nurse for a period of 1 year to assess their conditions and
 answer their queries. Patients will also be followed up in the respiratory clinic by
 respiratory specialist once every 3 months for 1 year.

 The control group will be managed as the usual care. The discharging physician will determine
 the patients' medication and follow up as in normal practice.

 All patients will be asked to return for assessments (spirometry, 6 minute walk test,
 questionnaires on the severity of dyspnoea and quality of life) at baseline and 12 months

 Main outcome measures: The primary endpoint is the hospital readmission rate and the
 secondary endpoints are the quality of life, mortality, lung function and exercise capacity
 of the patients.
Inclusion Criteria:

 -  Patients who are admitted to the Prince of Wales Hospital with AECOPD will be screened
 for this study.

 -  Patients with age over 40 years

 Exclusion Criteria:

 -  Patients with asthma

 -  Patients unable to provide informed consent