Clinical trial NCT02213809: Case Method Education on COPD to General Practitioners
Official title: Effect of Case Method Education to General Practitioners on Their Knowledge on COPD and on the Health of Their Patients With COPD
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: COPD
Lead sponsor: Karolinska Institutet
Sponsor class: OTHER
Collaborators: name: Dalarna County Council, Sweden
First posted: 2014-08-12
Enrollment: 822
Sex: ALL
Standard ages: CHILD
ADULT
OLDER_ADULT
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: Background:

COPD is an inflammatory and chronic obstructive lung disease, mainly caused by smoking. Most patients with COPD are discovered and treated in primary health care. Co-morbidity with heart disease, hypertension, diabetes, osteoporosis and underweight is common. It is important to diagnose COPD at an early stage, primarily to motivate smoking cessation, which is the most important factor for decelerating the progress of COPD. In addition, medication and rehabilitation to reduce symptoms of COPD can be given. Previous studies in Sweden have shown poor quality of primary health care provided to patients with COPD.

As general practitioners often deal with multiple medical problems and patients' motivation when diagnosing and treating COPD we hypothesize that case method education (see description under "intervention") in COPD has better effect than traditional education (see description under "intervention").This study aims to examine the effect of case method education on (1) learning in COPD among general practitioners and on (2) health in their patients with COPD.

Method:

Primary health care centers (PHCC) in Stockholm will be recruited. The PHCCs will be randomized to either case method education (n=9 PHCCs) or traditional education (n=9 PHCCs) in COPD for their general practitioners. The educations will be held during two times (two hours each) within a time range of three months, covering examination and treatment of patients with COPD. At least 10.000 patients should be listed at PHCCs included. Random sampling of 45 patients with COPD at stage 2-3 will be done from each PHCC. The patients will fill in a self-assessment questionnaire including CCQ, CAT and LINQ (see outcome measures) as well as questions about medication, exacerbations and other chronic diseases. The questionnaire will be sent to the patients 1-2 months before the education and 18 months after the education. Differences in assessments in the questionnaire before and after the education will be compared between the patients listed at the PHCCs that have received case method education vs. traditional education. In addition, general practitioners (approximately, n=180) at the PHCCs will fill in a questionnaire, immediately before and 12 months after the education, covering the learning outcomes in order to study differences in learning between the two intervention groups.


Eligibility criteria: Inclusion Criteria:

* Primary Health Care Centers (PHCC): \>10.000 patients listed. \>70% permanent employed general practitioners
* Patients: Diagnosis of COPD registered at the COPD. Grade of COPD 2-3 (GOLD) at the latest spirometry completed since 2008.

Exclusion Criteria:

* None

Primary outcomes:
measure: Difference i patients' assessment of Clinical COPD Questionnaire (CCQ) before the intervention and 18 months later.
timeFrame: 1-2 months before the intervention and 18 months after the intervention
measure: Difference in questionnaire about knowledge in COPD (questionnaire created by the research group)among the general practitioners that receive the education.
timeFrame: Immediately before the intervention and 12 months later.
Secondary outcomes:
measure: Difference i patients' assessment of Lung Information Needs Questionnaire (LINQ) before the intervention and 18 months later.
timeFrame: 1-2 months before the intervention and 18 months after the intervention
measure: Difference in patients' assessment of COPD Assessment Test (CAT) before the intervention and 18 months later.
timeFrame: 1-2 months before the intervention and 18 months after the intervention
Other outcomes:
Locations:
city: Huddinge
country: Sweden
facility: Department of Family Medicine, NVS, Karolinska Institutet
Study officials:
affiliation: Karolinska Institutet
name: Anna Nager, PhD
role: PRINCIPAL_INVESTIGATOR
affiliation: Karolinska Institutet
name: Hanna Sandelowsky, MD
role: STUDY_DIRECTOR
References:
citation: Sandelowsky H, Krakau I, Modin S, Stallberg B, Johansson SE, Nager A. Effectiveness of traditional lectures and case methods in Swedish general practitioners' continuing medical education about COPD: a cluster randomised controlled trial. BMJ Open. 2018 Aug 10;8(8):e021982. doi: 10.1136/bmjopen-2018-021982.
citation: Sandelowsky H, Krakau I, Modin S, Stallberg B, Nager A. Case Method in COPD education for primary care physicians: study protocol for a cluster randomised controlled trial. Trials. 2017 Apr 27;18(1):197. doi: 10.1186/s13063-017-1889-4.