Home and Community Care Digest
Method: A comprehensive database search was conducted to identify randomized controlled trials (RCTs) evaluating the effectiveness of home-based COPD nursing intervention programs featuring COPD education, and ongoing lung functioning assessment. Four trials were included and reviewed by two separate appraisers for methodological quality according to Cochrane Collaboration criteria. Three trials examined mortality after twelve months of care, and one looked at mortality at seven months. Data were abstracted and analyzed via standard research techniques.
Findings: Home nursing COPD did not significantly reduce overall mortality, but mortality for those with less severe COPD was improved. HRQOL was also improved for those with moderate disease only. No changes in exercise capacity and lung functioning were found across studies. No improvements in hospital admission rates were found in the one study that examined this outcome.
Conclusions: Nursing outreach COPD programs may improve HRQOL and related outcomes for COPD patients with mild to moderate disease. Those with severe COPD appear not to benefit from such programs. The impact of home COPD nursing programs on hospitalization rates among those with mild to moderate COPD has not been adequately examined.
Reference: Smith B, Appelton S, Adams R, Southcott A, Ruffin R. "Home care outreach nursing for chronic obstructive pulmonary disease". Cochrane Database of Systematic Reviews 2003; 1.
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