Better Respiratory Education and Treatment Help Empower (BREATHE) study: Methodology and baseline characteristics of a randomized controlled trial testing a transitional care program to improve patient-centered care delivery among chronic obstructive pulmonary disease patients

被引：18

作者：

Aboumatar, H. ^{[1
,2
,3
,4
]}

Naqibuddin, M. ^{[1
]}

Chung, S. ^{[1
]}

Adebowale, H. ^{[5
]}

Bone, L. ^{[4
,6
]}

Brown, T.

Cooper, L. A. ^{[2
,3
,4
]}

Gurses, A. P. ^{[1
,7
,8
,9
]}

Knowhon, A. ^{[3
]}

Kurtz, D. ^{[5
]}

Piet, L. ^{[5
]}

Putcha, N. ^{[10
]}

Rand, C. ^{[10
]}

Roter, D. ^{[3
,4
]}

Shattuck, E. ^{[11
]}

Sylvester, C. ^{[5
]}

Urteaga-Fuentes, A. ^{[1
]}

Wise, R. ^{[10
]}

Wolff, J. L. ^{[6
]}

Yang, T. ^{[1
]}

Hibbard, J. ^{[12
]}

Howell, E. ^{[1
,5
]}

Myers, M. ^{[13
]}

Shea, K. ^{[5
]}

Sullivan, J. ^{[14
]}

Syron, L. ^{[13
]}

Wang, Nae-Yuh ^{[2
,4
]}

Pronovost, P. ^{[1
,6
,7
]}

机构：

[1] Johns Hopkins Sch Med, Armstrong Inst Patient Safety & Qual, Baltimore, MD 21205 USA

[2] Johns Hopkins Univ, Div Gen Internal Med, Dept Med, Sch Med, Baltimore, MD 21218 USA

[3] Johns Hopkins Univ, Dept Hlth Behav & Soc, Bloomberg Sch Publ Hlth, Baltimore, MD 21218 USA

[4] Johns Hopkins Univ, Welch Ctr Prevent Epidemiol & Clin Res, Baltimore, MD 21218 USA

[5] Johns Hopkins Bayview Med Ctr, Baltimore, MD USA

[6] Johns Hopkins Univ, Bloomberg Sch Publ Hlth, Dept Hlth Policy & Management, Baltimore, MD 21218 USA

[7] Johns Hopkins Sch Med, Anesthesiol & Crit Care, Baltimore, MD USA

[8] Johns Hopkins Sch Med, Div Hlth Sci Informat, Baltimore, MD USA

[9] Johns Hopkins Univ, Whiting Sch Engn, Malone Ctr Engn Healthcare, Baltimore, MD 21218 USA

[10] Johns Hopkins Sch Med, Pulm & Crit Care Med, Baltimore, MD USA

[11] BREATHE Project, Baltimore, MD USA

[12] Univ Oregon, Hlth Policy Res Grp, Eugene, OR 97403 USA

[13] Johns Hopkins Home Care Grp, Baltimore, MD USA

[14] COPD Fdn, Miami, FL USA

来源：

CONTEMPORARY CLINICAL TRIALS | 2017年 / 62卷

基金：

美国国家卫生研究院;

关键词：

CLINICAL METHODS; ACTIVATION; COPD; INTERVENTIONS; MANAGEMENT; DYSPNEA;

D O I：

10.1016/j.cct.2017.08.018

中图分类号：

R-3 [医学研究方法]; R3 [基础医学];

学科分类号：

1001 ;

摘要：

Background: Chronic Obstructive Pulmonary Disease (COPD) is a leading cause of hospitalizations. Interventional studies focusing on the hospital-to-home transition for COPD patients are few. In the BREATHE (Better Respiratory Education and Treatment Help Empower) study, we developed and tested a patient and family-centered transitional care program that helps prepare hospitalized COPD patients and their family caregivers to manage COPD at home. Methods: In the study's initial phase, we co-developed the BREATHE transitional care program with COPD patients, family-caregivers, and stakeholders. The program offers tailored services to address individual patients' needs and priorities at the hospital and for 3 months post discharge. We tested the program in a single-blinded RCT with 240 COPD patients who were randomized to receive the program or 'usual care'. Program participants were offered the opportunity to invite a family caregiver, if available, to enroll with them into the study. The primary outcomes were the combined number of COPD-related hospitalizations and Emergency Department (ED) visits per participant at 6 months post discharge, and the change in health-related quality of life over the 6 months study period. Other measures include 'all cause' hospitalizations and ED visits; patient activation; self-efficacy; and, self-care behaviors. Discussion: Unlike 1 month transitional care programs that focus on patients' post-acute care needs, the BREATHE program helps hospitalized COPD patients manage the post discharge period as well as prepare them for long term self-management of COPD. If proven effective, this program may offer a timely solution for hospitals in their attempts to reduce COPD rehospitalizations.

引用

页码：159 / 167

页数：9

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