Translating The GOLD COPD Guidelines Into Primary Care Practice
Condition: Chronic Obstructive Pulmonary Disease (COPD)
MeSH terms: Lung Diseases; Lung Diseases, Obstructive; Pulmonary Disease, Chronic Obstructive
Study type: Interventional

Summary: 
      This project will evaluate the translation of the Gold (the Global Strategy for the
      Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease) COPD
      guidelines into primary care practice. During phase I, a needs assessment will evaluate
      barriers and facilitators to implementation of COPD guidelines into clinical practice through
      focus groups of primary care patients and providers. Using formative evaluation and feedback
      from the focus groups, three tools will be developed, refined and pilot tested. The
      effectiveness of the materials developed in phase I will be tested in phase II (a randomized
      clinical trial conducted with one year of intervention within non-academic primary care
      practices) regarding physician performance of COPD guideline implementation and improvement
      in the clinically relevant outcomes (appropriate screening, diagnosis and management of COPD)
      compared to usual care.
    

Detailed description: 
      This project will evaluate the translation of the GOLD (the Global Strategy for the
      Diagnosis, Management, and Prevention of Chronic Obstructive Pulmonary Disease) COPD
      guidelines into primary care practice. This study is based upon the premise that an informed,
      activated patient will interact with a prepared, proactive team to improve appropriate COPD
      screening, diagnosis and management. During phase I, a needs assessment will evaluate
      barriers and facilitators to implementation of COPD guidelines into clinical practice through
      focus groups of primary care patients and providers. Using formative evaluation and feedback
      from the focus groups, three tools will be developed, refined and pilot tested. These
      include: a computerized patient activation tool that will be used by the patient either in
      the waiting room or in the examination room; a web-based, interactive COPD guidelines tool to
      be used by primary care providers as a decision support tool at the point of care and a COPD
      patient education toolbox to be used by the practice team. During phase II, a block,
      randomized design cluster trial will be performed with one year of intervention within
      non-academic primary care practices (30 practices) throughout the state of Rhode Island and
      southeastern MA. The effectiveness of the materials developed in phase I will be tested in
      phase II regarding physician performance of COPD guideline implementation and the improvement
      in the clinically relevant outcomes (appropriate screening, diagnosis and management of COPD)
      compared to usual care. The investigators will also examine the use of a patient activation
      tool -'MyLungAge' to prompt patients to talk with their health care provider regarding their
      lung health and risk for COPD. Products for dissemination from this grant will include the
      results of the focus groups barriers and facilitators to implementation and adherence to COPD
      guidelines, a computerized data collection module for quality of care assessment regarding
      COPD guidelines, a refined computerized patient activation tool, an enhanced web-based COPD
      interactive guideline tool, tailored academic detailing materials, and the results of the
      randomized clinical trial on the effectiveness of these tools to improve COPD guideline
      adherence in primary care practice.
    

Intervention name(s): provider support tools plus spirometer
Intervention type(s): Other
Intervention description(s): Patient Activation Tool, Provider Web-based decision support tool, academic detailing
Other intervention name(s): Determine the effectiveness of tools developed in improving guideline implementation and adherence.
Allocation: Randomized
Intervention model: Parallel Assignment
Masking: None (Open Label)
Primary purpose: Other
Keywords: Chronic Obstructive Pulmonary Disease; COPD Guidelines; Patient Activation; Lung Age