Intervention effect of contracted family doctor service-based follow-up management on community patients with chronic obstructive pulmonary disease: a case-control study

  Objective   To evaluate intervention effect of contracted family doctor service-based follow-up management on community patients with chronic obstructive pulmonary disease (COPD) for exploring appropriate management pattern to improve the quality of life of COPD patients.

  Methods   Totally 82 COPD patients were randomly recruited at a community health service center in Hohhot city of Inner Mongolia Autonomous Region and assigned into an intervention and a control group (41 in each group) for a 6-month follow-up study conducted from September 2015 to September 2016. During the study period, the patients in control group received routine treatment (oral administration of carboxymethylstan and aminophylline); the patients of intervention group had both the routine treatment and follow-up home visits by contracted family doctors at frequencies of once in a week/two weeks/three weeks and four weeks in the first/second/third and the last three month, respectively. At the end of study, all the patients′ information on basic knowledge about COPD, treatment compliance, and the activity ability and quality of life before and after intervention were collected with a self-designed questionnaire and Seattle Obstructive Pulmonary Disease Questionnaire (SOLDQ) – Chinese version; the patients′ forced expiratory volume in 1 second (FEV₁), forced vital capacity (FVC), FEV₁/ FVC ratio and maximum ventilation volume per minute (MVV) were determined before and after the follow-up study.

  Results   Compared to the patients of control group at the end of the intervention, the COPD patients of the intervention group had significantly higher rate of awareness on basic knowledge about COPD (100% vs. 56.1%, χ² = 7.987; P < 0.001) and compliance rates for smoking cessation (43.9% vs. 9.8%), regular medication (97.6% vs. 46.3%), respiratory exercise (96.3% vs. 48.8%), and home oxygen therapy (85.4% vs. 56.1%) (all P < 0.05). There were no significant differences in the activity capacity, quality of life, and lung function indexes (FEV₁, FVC, and MVV) between the patients of the two groups before intervention (all P > 0.05); but after the intervention, the patients in the intervention group manifested significantly better activity capacity and quality of life and improved lung function indexes including FEV₁, FVC, FEV₁/ FVC, and MVV in comparison with those of the control group (all P < 0.05).

  Conclusion   Contracted family doctor service-based follow-up management on community COPD patients could promote the patients′ basic knowledge about the disease and improve the the patients′ treatment compliance, activity ability, quality of life, and pulmonary function.