The assessment of burden of COPD tool improves health related quality of life

Background We developed the Assessment of Burden of COPD (ABC) tool consisting of a short validated questionnaire assessing the experienced burden of COPD (Slok et al, COPD: Journal of COPD 2016; epub ahead of print), objective COPD severity indicators (e.g., lung function), and a treatment algorithm visualising outcomes (Figure 1) and providing treatment options. The tool can be used in daily COPD care and can facilitate communication, shared decision making and self-management. Aim Our aim was to assess the effectiveness of the tool on the quality of life, (SGRQ), and perceived quality of care, (Patient Assessment of Chronic Illness Care (PACIC)). Methods We conducted a cluster randomized controlled trial in COPD patients. In the intervention group the ABC tool was applied and in the control group usual care. The primary outcome was a clinically relevant improvement (SGRQ≤4 points) between baseline and 18 months follow-up. Mixed logistic and linear regression was used. Results A total of 56 healthcare providers with 357 patients participated. After 18 months 34% in the intervention group had a clinical relevant improvement on the SGRQ, compared with 22% in the control group (OR 1.85; 95%CI 1.08 to 3.16). Perceived quality of care also improved more in the intervention group (0·32 points: 95%CI, 0·14 to 0·50). Conclusions The ABC tool seems to improve disease-specific quality of life and perceived quality of care in patients with COPD.