Please select the arm or intervention descriptions that belong to the clinical trial below.
Title: Program of Integrated Care for Patients With Chronic Obstructive Pulmonary Disease and Multiple Comorbidities: A Randomized Controlled Trial
Brief Summary: Many patients with chronic obstructive pulmonary disease (COPD) also have other diseases referred to as comorbidities. Often these patients require health care by a variety of health care professionals from services linked to hospitals and in the community. Unfortunately, sometimes it may be difficult for these patients to receive appropriate care in a timely manner resulting in a trip to the emergency department. As well, patients may benefit from education that enables them to recognize early signs indicating they are getting sicker and to self-manage their disease. Our study will examine a strategy that includes a case manager who will make weekly phone contact with COPD patients with comorbidity that present either to the emergency department or are admitted to hospital. Weekly contact will focus on teaching patients to recognize worsening symptoms and self-management strategies. The case manager will work with patients, caregivers, community health care providers and hospital specialists to promote communication and optimize care delivery. The investigators will examine the impact of our intervention on the need for emergency department visits and hospital admission. The investigators will also examine the impact on patients' health related quality of life, number of COPD exacerbations, and disease progression.


Options:
A: Arm Label: iVAPS with AutoEPAP; Type: EXPERIMENTAL; Interventions: Device: Astral | Arm Label: iVAPS with manual EPAP; Type: ACTIVE_COMPARATOR; Interventions: Device: Astral | Intervention Type: DEVICE; Name: Astral; Assigned to Arm(s): iVAPS with AutoEPAP, iVAPS with manual EPAP
B: Arm Label: Tiotropium low; Type: EXPERIMENTAL; Interventions: Drug: Tiotropium low | Arm Label: Tiotropium medium; Type: EXPERIMENTAL; Interventions: Drug: Tiotropium medium | Arm Label: Tiotropium high; Type: EXPERIMENTAL; Interventions: Drug: Tiotropium high | Arm Label: Tiotropium 18mcg; Type: ACTIVE_COMPARATOR; Interventions: Drug: Tiotropium 18mcg | Arm Label: Tiotropium placebo; Type: PLACEBO_COMPARATOR; Interventions: Drug: Tiotropium placebo | Intervention Type: DRUG; Name: Tiotropium medium; Assigned to Arm(s): Tiotropium medium | Intervention Type: DRUG; Name: Tiotropium low; Assigned to Arm(s): Tiotropium low | Intervention Type: DRUG; Name: Tiotropium high; Assigned to Arm(s): Tiotropium high | Intervention Type: DRUG; Name: Tiotropium 18mcg; Assigned to Arm(s): Tiotropium 18mcg | Intervention Type: DRUG; Name: Tiotropium placebo; Assigned to Arm(s): Tiotropium placebo
C: Arm Label: Case Management; Type: EXPERIMENTAL; Interventions: Behavioral: 40 minute standardized education session, Behavioral: Individualized action plan, Behavioral: Individualized care plan, Behavioral: Standardized reinforcement/motivational interviewing and action plan teach-back sessions, Behavioral: Tele-home monitoring, Behavioral: Coordinated and improved communication, Behavioral: Priority access, Behavioral: Dictated patient summary, Behavioral: in-hospital rehabilitation/self-management program, Behavioral: Smoking cessation | Arm Label: Usual care; Type: ACTIVE_COMPARATOR; Interventions: Behavioral: Dictated patient summary, Behavioral: in-hospital rehabilitation/self-management program, Behavioral: Smoking cessation, Behavioral: Action plan Respirologist, Behavioral: Web based self management materials | Intervention Type: BEHAVIORAL; Name: 40 minute standardized education session; Assigned to Arm(s): Case Management | Intervention Type: BEHAVIORAL; Name: Individualized action plan; Assigned to Arm(s): Case Management | Intervention Type: BEHAVIORAL; Name: Individualized care plan; Assigned to Arm(s): Case Management | Intervention Type: BEHAVIORAL; Name: Standardized reinforcement/motivational interviewing and action plan teach-back sessions; Assigned to Arm(s): Case Management | Intervention Type: BEHAVIORAL; Name: Tele-home monitoring; Assigned to Arm(s): Case Management | Intervention Type: BEHAVIORAL; Name: Coordinated and improved communication; Assigned to Arm(s): Case Management | Intervention Type: BEHAVIORAL; Name: Priority access; Assigned to Arm(s): Case Management | Intervention Type: BEHAVIORAL; Name: Dictated patient summary; Assigned to Arm(s): Case Management, Usual care | Intervention Type: BEHAVIORAL; Name: in-hospital rehabilitation/self-management program; Assigned to Arm(s): Case Management, Usual care | Intervention Type: BEHAVIORAL; Name: Smoking cessation; Assigned to Arm(s): Case Management, Usual care | Intervention Type: BEHAVIORAL; Name: Action plan Respirologist; Assigned to Arm(s): Usual care | Intervention Type: BEHAVIORAL; Name: Web based self management materials; Assigned to Arm(s): Usual care
D: Intervention Type: DRUG; Name: Tiotropium; Assigned to Arm(s): N/A

Answer: C