Clinical efficacy of the COPDnet integrated care model

Introduction: We developed an evidence-based, integrated care model for patients with COPD referred to secondary care, i.e. the COPDnet model (Koolen et al. Int J COPD 2018). The COPDnet model has been implemented in two hospitals and affiliated primary care region in the Netherlands. The clinical efficacy was evaluated in a prospective, observational study. Interim results were presented at the ERS congres in 2019. Final results are presented here. Methods: The Clinical COPD Questionnaire (CCQ) was used as primary endpoint to compare health status at baseline, that is at the time of referral to secondary care, and eight months later. An analysis was performed for all patients and for four subgroups based on the type of intervention they received: (1) only pharmacological, (2) self-care, (3) monodisciplinary allied healthcare professional (HCP) in primary care, or, (4) interdisciplinary in- or outpatient pulmonary rehabilitation. Results: For final analysis data from 154 patients were available: 50% male, age 63±8, FEV1 1.55±0.66 L. (53±19% pred.). CCQ decreased from 1.94±1.04 to 1.72±0.94 for all patients. This reduction is statistically significant (P=0.001) but not clinically relevant. Figure 1 shows the results per subgroup. Only the interdisciplinary rehabilitation resulted in a statistically significant & clinically relevant better CCQ. Conclusion: The COPDnet model significantly improves health status. Interdisciplinary rehabilitation contributes most.