Effects of chronic disease management on pulmonary function, SGRQ score and acute exacerbation in patients with chronic obstructive pulmonary disease

Objective To study the effects of chronic disease management on pulmonary function (FEV1, FEV1pred %), St. George′s respiration Questionnaire score (SGRQ score) and acute exacerbation of chronic obstructive pulmonary disease (COPD). Methods 256 cases of COPD patients diagnosed by pulmonary function were randomly selected, and then randomly divided into the Chronic Disease management Group and the Natural Course control group. After the patients were enrolled, they were divided into four groups: A, B, C and D according to the combined evaluation of GOLD 2015, and the SGRQ score was also performed. Followed up every three months, the patient's condition, drug applications were recorded in their respective medical records. Patients in chronic disease management group received six stages of COPD related knowledge training, and smokers work together to develop a smoking cessation strategy, according to the patient′s combined assessment of the group to give normative drug treatment program, guide patients rehabilitation exercise. The patients in the natural course control group only recorded the change of the condition and the application of the medicine, without intervention. Two groups of patients were administered for one year. The lung function, SGRQ score and exacerbation times of two groups of patients and four subgroups of A, B, C and D were compared and analyzed. Results there was no significant difference in lung function and SGRQ score between the two groups before and after the management of chronic diseases. The number of acute exacerbations in the management group was significantly less than that in the control group. A comparative analysis of the four subgroups of patients showed that the lung function and SGRQ score of Group A were not significantly changed; The lung function and SGRQ score of the Group B and C in the management group were significantly improved, and the lung function of Group B and C in the control group was lower than before, the SGRQ score was increased, but the change was not significant, the lung function of patients in Group D decreased significantly, the SGRQ score of management group was increased, but no significant change, and the SGRQ score of the control group was significantly higher than before, there was no significant difference between the two subgroups in one years. The acute exacerbation times in Group B and C were significantly lower in management group than in control group , and in Group A and D patients, there was no significant difference between management Group and control group. Conclusion COPD patients with chronic disease management, although not significantly improve their lung function and SGRQ scores, but can reduce the number of acute exacerbations. Chronic disease management can improve the lung function, SGRQ score, reduce the symptoms, reduce the frequency of acute exacerbation and improve the quality of life in group B and group C, but have no significant influence on group A and group D. Key words: Pulmonary disease, chronic obstructive; Patient education; Quality of life; Follow-up study