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Can the COPD web be used to promote self-management in patients with COPD in swedish primary care: a controlled pragmatic pilot trial with 3 month- and 12 month follow-up
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy. School of Education Health and Social studies, Dalarna University, Falun, Sweden.
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Section of Physiotherapy.
2019 (English)In: Scandinavian Journal of Primary Health Care, ISSN 0281-3432, E-ISSN 1502-7724, Vol. 37, no 1, p. 69-82Article in journal (Refereed) Published
Abstract [en]

Objective: Evaluate the feasibility of the COPD Web and its study design and study procedures and to increase the understanding of the potential effect of the tool in order to provide guidance for a future large scale trial.

Design: Parallel-group controlled pragmatic pilot trial.

Subjects: There was a total of 83 patients with COPD (mean age 70 +/- 8 years with a forced expiratory volume in first second percent predicted of 60 +/- 17%). The intervention group (n = 43) was introduced to and had access to the COPD Web in addition to usual care, while the control group (n = 40) received usual care alone.

Main outcome measures: The feasibility of the COPD Web (i.e., if and how the COPD Web was used) was automatically collected through the website, while outcomes on health, conceptual knowledge, and physical activity (PA) were collected through questionnaires at baseline, 3 months and 12 months.

Results: At 3 months, 77% of the intervention group was considered users, and the majority of time spent on the site was related to PA and exercises and was spent during the first month (>80%). In addition, the intervention group reported increased PA (odds ratio [OR] = 4.4, P < .001), increased conceptual knowledge in five domains (OR = 2.6-4.2, all P < .05), and altered disease management strategies (e.g., increased PA) (OR >= 2.7 P < .05) in comparison to the control group. The latter was also different between groups at 12 months (OR = 3.7, P = .044). Knowledge of PA was correlated with level of PA (rho = .425-.512, P < .05) as well as to the use of PA as a strategy to manage their disease (chi(2) = 11.2-32.9, P < .05).

Conclusion: Giving patients with COPD access to the COPD Web in addition to their ordinary primary care might be an effective shorter term (3 month) strategy to promote self-management. However, these results needs to be confirmed in a definitive large-scale trial.

Place, publisher, year, edition, pages
Taylor & Francis, 2019. Vol. 37, no 1, p. 69-82
Keywords [en]
COPD, physical activity, self-management, pragmatic trial, internet-based
National Category
Physiology
Identifiers
URN: urn:nbn:se:umu:diva-158765DOI: 10.1080/02813432.2019.1569415ISI: 000462849900009PubMedID: 30700230OAI: oai:DiVA.org:umu-158765DiVA, id: diva2:1315207
Available from: 2019-05-13 Created: 2019-05-13 Last updated: 2019-05-13Bibliographically approved

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