Expert Patient Self-management Programme Versus Usual Care in Bronchiectasis

Overview

The aim of this exploratory randomized controlled trial was to investigate the efficacy of a disease specific Expert Patient Programme compared to usual care in patients with bronchiectasis. Hypothesis: Disease specific EPP will increase self efficacy compared to usual care.

Study Type

  • Study Type: Interventional
  • Study Design
    • Allocation: Randomized
    • Intervention Model: Parallel Assignment
    • Primary Purpose: Treatment
    • Masking: Single (Outcomes Assessor)
  • Study Primary Completion Date: October 2007

Interventions

  • Behavioral: Expert Patient Programme
    • Intervention was a disease specific Expert Patient Programme in addition to usual care. The disease specific Expert Patient Programme was delivered one session per week (lasting 2½ hours) for eight weeks and included 2 weeks disease specific education followed by 6 weeks standardised Expert Patient Programme.
  • Behavioral: Usual care
    • Usual care included reviews at a specialist respiratory clinic on a three monthly basis to monitor spirometry, inflammatory blood markers and sputum microbiology. The patients were prescribed inhaled therapy and antibiotics if required, and treatment adjusted to the needs of the patient as necessary, including hospital admission.

Arms, Groups and Cohorts

  • Other: Usual care
    • Usual care included reviews at a specialist respiratory clinic on a three monthly basis to monitor spirometry, inflammatory blood markers and sputum microbiology. The patients were prescribed inhaled therapy and antibiotics if required, and treatment adjusted to the needs of the patient as necessary, including hospital admission.
  • Experimental: Expert Patient Programme
    • Receives a disease specific Expert Patient Programme in addition to usual care. The disease specific Expert Patient Programme was delivered one session per week (lasting 2½ hours) for eight weeks and included 2 weeks disease specific education followed by 6 weeks standardised Expert Patient Programme.

Clinical Trial Outcome Measures

Primary Measures

  • Self-efficacy
    • Time Frame: 8 months
    • Self efficacy is measured using the Chronic Disease Self Efficacy Scale. Confidence is measured on a 1-10 point Likert scale for 10 subscales. There are no specific units for this measurement.

Secondary Measures

  • Perception of illness
    • Time Frame: 8 months
    • Perception of illness is measured using the Illness Perception Questionnaire – revised IPQ-R. This questionnaire has 8 domains. Minimum score 52 and maximum 204. There are no specific units for this measurement.
  • Health related quality of life
    • Time Frame: 8 months
    • Health related quality of life is measured using the St Georges Respiratory Questionnaire. This questionnaire has 3 domains. Min-max scores 0-100%
  • Self rated health
    • Time Frame: 8 months
    • An expert patient programme questionnaire is used to record self rated health, management of condition, days lost to work and social activities, satisfaction and benefits. There are no specific units for this measurement.
  • Lung function
    • Time Frame: 8 months
    • Spirometric measurement of FEV1 expressed as a percentage predicted is used to assess lung function
  • Rate of exacerbation
    • Time Frame: 8 months
    • Frequency of antibiotics is recorded to assess rate of exacerbation. These will be expressed as the number of antibiotics prescribed per group during the study.

Participating in This Clinical Trial

Inclusion Criteria

  • Adult patients (>18 years) with a primary diagnosis of bronchiectasis based on a respiratory physician's assessment including a computed tomography scan were included in the study Exclusion Criteria:

  • Primary diagnosis of cystic fibrosis – Patients with methicillin-resistant Staphylococcus aureus infection – Patients with any condition that would have an impact on the assessment procedures (e.g. sensory impairment, pregnancy, language barriers) – Any factor that would prevent adherence to the self-management programme.

Gender Eligibility: All

Minimum Age: 18 Years

Maximum Age: N/A

Are Healthy Volunteers Accepted: No

Investigator Details

  • Lead Sponsor
    • Belfast Health and Social Care Trust
  • Collaborator
    • University of Ulster
  • Provider of Information About this Clinical Study
    • Dr Judy Bradley, Belfast Health and Social Care TRust
  • Overall Official(s)
    • Judy M Bradley, PhD, Principal Investigator, Belfast Health and Social Care Trust & University of Ulster

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