Impact of Proactive Integrated Care on Chronic Obstructive Pulmonary Disease
Patricia B. Koff, Sung‐Joon Min, Tammie J. Freitag, Debora L. P. Diaz, Shannon S. James, Norbert F. Voelkel, Derek J. Linderman, Fernando Diaz del Valle, Jonathan K. Zakrajsek, Richard Albert, Todd Bull, Arne Beck, Thomas J. Stelzner, Debra P. Ritzwoller, Christine Kveton, Stephanie Carwin, Moumita Ghosh, Robert L. Keith, John M. Westfall, R. William Vandivier
Abstract
BACKGROUND: Up to 50% of chronic obstructive pulmonary disease (COPD) patients do not receive recommended care for COPD. To address this issue, we developed Proactive Integrated Care (Proactive iCare), a health care delivery model that couples integrated care with remote monitoring. METHODS: We conducted a prospective, quasi-randomized clinical trial in 511 patients with advanced COPD or a recent COPD exacerbation, to test whether Proactive iCare impacts patient-centered outcomes and health care utilization. Patients were allocated to Proactive iCare (n=352) or Usual Care ( =159) and were examined for changes in quality of life using the St George's Respiratory Questionnaire (SGRQ), symptoms, guideline-based care, and health care utilization. FINDINGS: =0.08). INTERPRETATION: Linking integrated care with remote monitoring improves the lives of people with advanced COPD, findings that may have been made more relevant by the coronavirus 2019 (COVID-19) pandemic.