The feasibility of an innovative GP-physiotherapist partnership to identify and manage chronic obstructive pulmonary disease (INTEGRATED): study protocol

Pilot and Feasibility Studies

Stephen Crone¹  Lisa Pagano²  Zoe McKeough²  Sally Wootton³  Sarah Dennis⁴  Nicholas Zwar⁵  Andrew S. L. Chan⁶  Sriram Mahadev⁶  Deborah Pallavicini⁷ 

[1] Chronic Disease Community Rehabilitation Service, Northern Sydney Local Health District, St Leonards, Australia;Discipline of Physiotherapy, University of Sydney, Sydney, Australia;Discipline of Physiotherapy, University of Sydney, Sydney, Australia;Chronic Disease Community Rehabilitation Service, Northern Sydney Local Health District, St Leonards, Australia;Discipline of Physiotherapy, University of Sydney, Sydney, Australia;Ingham Institute for Applied Medical Research, Liverpool, Australia;South Western Sydney Local Health District, Liverpool, Australia;Faculty of Health Sciences, The University of Sydney, 75 East Street, 2141, Lidcombe, NSW, Australia;Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia;Royal North Shore Hospital, St Leonards, Australia;Northern Clinical School, University of Sydney, Sydney, Australia;Sydney North Primary Health Network (SNPHN), St Leonards, Australia;

关键词: COPD;    Primary care;    Pulmonary rehabilitation;    Physical activity;    Screening;    Physiotherapy/physical therapy;   

DOI  :  10.1186/s40814-020-00680-4

来源: Springer

【 摘 要 】

BackgroundChronic obstructive pulmonary disease (COPD) contributes significantly to mortality, hospitalisations and health care costs worldwide. There is evidence that the detection, accurate diagnosis and management of COPD are currently suboptimal in primary care. Physiotherapists are well-trained in cardiorespiratory management and chronic care but are currently underutilised in primary care. A cardiorespiratory physiotherapist working in partnership with general practitioners (GPs) has the potential to improve quality of care for people with COPD.MethodsA prospective pilot study will test the feasibility of an integrated model of care between GPs and physiotherapists to improve the diagnosis and management of people with COPD in primary care. Four general practices will be selected to work in partnership with four physiotherapists from their local health district. Patients at risk of developing COPD or those with a current diagnosis of COPD will be invited to attend a baseline assessment with the physiotherapist, including pre- and post-bronchodilator spirometry to identify new cases of COPD or confirm a current diagnosis and stage of COPD. The intervention for those with COPD will involve the physiotherapist and GP working in partnership to develop and implement a care plan involving the following tailored to patient need: referral to pulmonary rehabilitation (PR), physical activity counselling, medication review, smoking cessation, review of inhaler technique and education. Process outcomes will include the number of people invited and reviewed at the practice, the proportion with a new diagnosis of COPD, the number of patients eligible and referred to PR and the number who attended PR. Patient outcomes will include changes in symptoms, physical activity levels, smoking status and self-reported exacerbations.DiscussionIf feasible, we will test the integration of physiotherapists within the primary care setting in a cluster randomised controlled trial. If the model improves health outcomes for the growing numbers of people with COPD, then it may provide a GP-physiotherapist model of care that could be tested for other chronic conditions.Trial registrationANZCTR, ACTRN12619001127190. Registered on 12 August 2019—retrospectively registered.

【 授权许可】

CC BY