Please select the eligibility criteria that correspond to the clinical trial below.
Title: A Randomised Control Trial Assessing the Effects of an Intermediate Care Package in Preventing Hospitalisation of Elderly Patients With Chronic Obstructive Pulmonary Disease (COPD)
Brief Summary: Chronic obstructive pulmonary disease (COPD) is a term used for the conditions of chronic bronchitis and emphysema, diseases that are very common among the elderly and diseases that account for up to15% of all general medical admissions to National Health Service Hospitals. In a recent report on emergency admissions to acute hospitals in London, the King's Fund concluded that taking better care of elderly patients with COPD could reduce pressures on acute hospitals, and suggested that identification of vulnerable patients with lung disease and "pro-active," rather than "reactive," management might reduce the chances of hospitalisation. In this study, the investigators wish to compare a group of patients with COPD who are managed in the normal way, with another group of patients with COPD who receive all interventions known to be of some benefit to those with this condition. This will include a pulmonary rehabilitation programme, intensive education regarding self care, targeted advice to their general practitioners regarding how best to manage COPD, and regular contact with specialist respiratory nurses who will support the patients in their own homes by a combination of home visits and telephone contact. The value of such a comprehensive intervention will be studied, in terms of both its ability to reduce admissions to the hospital and its impact on quality of life.


Options:
A: Inclusion Criteria:

* 40 yr of age
* FEV1 70%
* FEV1/FVC \< 70%
* RV/TLC 120%
* mean SpO2 90% at peak exercise (w/ or w/o O2)
* Able to hear metronome sounds Lives near Hines, IL (Chicagoland area)

Exclusion Criteria:

* Respiratory infection/exacerbation within the previous four weeks
* Exercise limiting heart disease (+ stress test or other indicators of heart disease or complaints of angina during the stress test)
* Primary asthma
* Congestive heart failure (New York Heart Association Class III or IV)
* Exercise-limiting peripheral arterial disease (stops exercise due to intermittent claudication)
* Stops exercise due to arthritic pain in the knee or hips (self-report)
* Inability to walk on the treadmill
* Pregnancy
* Any unforeseen illness or disability that would preclude exercise testing or training
* Participation in a formal exercise program within the previous 12 weeks
B: Inclusion Criteria:

* National registration within the Västra Götaland Region (VGR)
* Men and women listed at a primary care centre in Närhälsan with a history of confirmed diagnosis of COPD and /or CHF
* Must understand written and spoken Swedish

Exclusion Criteria:

* Severe impairment that prevents patient from using the eHealth support
* No registered address
* Any severe disease with an expected survival \< 12 months
* Cognitive impairment (SPMSQ score \>6)
* Ongoing documented diagnosis of alcohol or drug abuse
* Other disease that can interfere with follow-up (e.g. severe depression, other severe mental illness)
* Patient participating in another conflicting randomized study
C: Inclusion Criteria:

* Patients over the age of 50 with COPD
* Admitted to Charing Cross Hospital in 2000-2004 with an acute exacerbation of COPD

Exclusion Criteria:

* Significant co-morbidity including severe heart disease and cancer
* Any condition that would preclude participation in the physical therapy component of a pulmonary rehabilitation programme, including musculoskeletal diseases
D: Inclusion Criteria:

* COPD new GOLD classification (B, C and D class) and a spirometry in the previous year and
* Systolic and/or diastolic CHF defined at least by an echocardiogram performed in clinical stability; II, III and IV New York Heart Association class and optimized drug therapy.
* Informed consent signed

Exclusion Criteria:

* Physical activity limitations caused by non-cardiac and/or pulmonary problems
* Obstructive Cardiomyopathies and/or myocarditis
* Non cardiac and/or pulmonary pathologies that would cause the death of the patient during the study
* Poor adherence and compliance of the patient

Answer: C