Editorials

Integrated disease management for adults with chronic obstructive pulmonary disease

BMJ 2014; 349 doi: https://doi.org/10.1136/bmj.g5675 (Published 19 September 2014) Cite this as: BMJ 2014;349:g5675
  1. Jean Bourbeau, professor, McGill University Health Centre
  1. 1Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute, Montréal, QC, Canada, H2X 2P4
  1. Correspondence to: jean.bourbeau{at}mcgill.ca

We still have a lot to learn about how to make it work in primary care

Chronic obstructive pulmonary disease (COPD) places an enormous burden on patients, families, and healthcare systems. Optimal care of COPD patients requires a patient centered approach that recognizes and treats all aspects of the disease and integrates medical care among healthcare professionals and across healthcare sectors. Integrated disease management, a system of coordinated healthcare interventions and communications for patients with chronic disease in which self management by patients is important, has been proposed as a model. A recent Cochrane review found clinically relevant reductions in admissions and days in hospital and improvements in exercise tolerance and health related quality of life, mostly for adults with severe COPD, with integrated disease management programs in secondary care.1 However, we should not assume that programs with proven effectiveness in secondary care transfer readily to primary care settings.

In the linked paper (doi:10.1136/bmj.g5392), Kruis and colleagues report the results of an important trial to evaluate the benefits of integrated disease management and to help to improve our understanding of transferring its components to a family practice setting.2 Components tested in the RECODE trial include …

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