Efficacy of Disease Management Programs Asthma and COPD? Results of a Cross-Sectional Study

Background The efficacy of the German disease management programs (DMP) asthma and chronic obstructive pulmonary disease (COPD) cannot be shown with the legally bound documentations. Studies with control groups are rare. Aim of this work was to investigate in a cross-sectional study whether the disease control differs in participants (DMP+) and non-participants (DMP-) of the DMPs asthma and COPD. Methods The study was a prospective multicenter cross-sectional study. Primary endpoints were the Asthma Control Test (TM) (ACT) in the asthma part of the study and the COPD Assessment TestT (CAT) for the COPD part. Results A total of 1038 asthma patients and 846 COPD patients were included, of whom about 70% participated in the corresponding DMP. The ACT total score was higher in asthma DMP+ patients than in DMP-patients (mean difference 0.86; 95% CI: 0.29-1.43;p = 0.003), but not clinically relevant. For COPD there was no clinically relevant difference in COPD disease impact (0.52; 95% CI:-0.71-1.75; p = 0.405). Although DMP patients had to be enrolled in the respective DMP for at least one year, only 60% of these patients had participated in a structured education. We did not observe a difference in disease control in DMP patients who respectively participated and did not participate in a structured education. Discussion There was no clinically relevant difference in disease control between DMP+ and DMP-patients. The efficacy of DMPs has been demonstrated internationally in randomized controlled trials. Randomized controlled trials should be conducted in Germany for demonstrating efficacy of DMPs asthma and COPD. Registration drks. de, DRKS00007664, Registration date: Jan 15, 2015