Curative effect evaluation of community health management to Taiyuan elderly health cadres with stable chronic obstructive pulmonary disease

Objective The research aims to evaluate the curative effects of community health management interventions on stable chronic obstructive pulmonary disease (COPD). Methods The research is based on the information of 252 COPD patients who are over the age of 65. They were randomly selected from 12 communities of Taiyuan city. With the assessment of their baseline information, the patients were randomly assigned to the experimental group and the control group. A set of comprehensive intervention measures were applied to the patients of experimental group, such as health education, specification of drug therapy and pulmonary rehabilitation training. In addition, the patients were advised to see their doctors regularly or the doctors followed up their patients actively. While there was only specification of drug therapy for the control group. Patients were followed up for 1 year. The patients of two groups were given the tests before and after the management as follows: FEV1/FVC, FEV1/pred, mMRC, CAT, Acute exacerbation frequency, 6MWD and SF-MNA. And the results were compared within and between groups by student t test for normal distributed data, non-parametric analysis for abnormal distributed data, Chi-square test for categorical data. Results There was a significant difference in FEV1%pred, mMRC, CAT, 6MWD and MNA-SF in experimental group after treatment (t=3.584, 12.151, 17.156, -21.911, -10.500, and P < 0.01); There was a significant difference within the statistics of the control group before and after the intervention in FEV1/FVC, FEV1%pred, mMRC, CAT, 6MWD (t=4.145, 5.038, 5.653, -5.777, -9.749, and P < 0.01). There was a significant difference in FEV1/FVC, CAT, 6MWD between the two groups before the intervention (t=4.754, -4.758, 4.026, and P < 0.05); and a significant difference in mMRC, MNA-SF, FEV1/FVC, CAT, 6MWD between the two groups after the intervention (t=-12.267, 6.675, 10.599, -10.166, 21.811, and P < 0.01). There was a significant difference in the constituent ratio of acute exacerbation frequency. The frequency of the experimental group was less than the control group (χ2=19.33, P < 0.01). Conclusion It is possible to improve the symptoms of dyspnea, enhance the quality of life, boost the exercise tolerance, improve the nutrition state and decrease the risk of worsening through community management intervention in the elderly with COPD. Key words: Aged; Administrative personnel; Pulmonary disease, chronic obstructive; Community health service; Disease management