‘Care on demand’ is effective in COPD patients

A ‘care on demand’ system could probably replace stand visits to the outpatient clinic for patients with COPD. This ‘care on demand’ system allows patients to request help if their symptoms worsen. This would mean fewer exacerbations, fewer visits to the general practitioner, pulmonary outpatient clinic, and fewer hospital admissions. This is the conclusion of research by Farida Berkhof, based at the Isala Hospital in Zwolle, in collaboration with the UMCG. Her research also shows that this system does not have a negative impact on patients’ quality of life. She will be awarded a PhD from the University of Groningen for her thesis on 29 April.

Chronic Obstructive Pulmonary Disease (COPD) is a progressive pulmonary disease with deterioration over time. The prevalence is increasing. COPD is characterized by varying stable periods and acute exacerbations– a sudden flare-up that includes increased coughing, mucous production and shortness of breath. An exacerbation can lead to deterioration in the patient’s health as well as hospital admission or drug-based treatment. It is difficult to predict an exacerbation. For her thesis, Farida Berkhof investigated whether this deterioration could be detected and treated at an earlier stage. She also explored whether visits to the outpatient clinic and hospital admissions could be reduced, and whether deterioration in the patient’s health could be prevented.

‘Care on demand’ system

Berkhof investigated a ‘care on demand’ system in which COPD patients received instructions on how they could and should ask for help if their symptoms worsened. The system seemed to have a positive effect. Berkhof: ‘It led to fewer outpatient visits to general practitioner and fewer exacerbations in patients with COPD. Furthermore, their quality of life seemed to remain the same.’ The system is for both, the healthcare provider and the health insurance, cost effective and thus seems to be a safe and attractive option. It is currently the standard treatment method for this disease at the Isala Hospital in Zwolle.

Berkhof also investigated another system in which a pulmonary nurse specialist phoned patients with COPD every two weeks to monitor their symptoms. The patients received treatment if their symptoms worsened. Her research suggests that this actually leads to an increase in exacerbations and outpatient clinic visits and deterioration in the patient’s health. Berkhof believes this is probably because the frequent contact only serves to remind patients of their chronic disease and symptoms. She does not recommend implementing this system.

Curriculum Vitae

F.F. Berkhof (Zeist, 1982) studied Medicine at the University Medical Center Utrecht. She conducted her PhD research at the Lung Diseases department of Isala Hospital in collaboration with the University Medical Center Groningen’s GUIDE research institute. Her thesis is entitled Measurement and Improvement of Health Status in Patients with COPD. She is currently training at the UMCG to become a GP.

Source: press release UMCG