A computer-based intervention to help COPD patients improve their lifestyle.

The goal of this project is to improve the self management of COPD patients with the help of information
technology as part of a disease-management approach. We will integrate two existing evidence-based methods to realize this goal. The first method is a disease-management approach with EPR support that has been validated for diabetes care. The second method is a computer-tailored feedback approach for patient self management that has been validated for smoking and physical activity. Both methods have been developed at University Maastricht.



In the Maastricht region a Diagnosis-Treatment Combination (DBC) reimbursement system for COPD
will be implemented in 2008. This DBC is based on our validated disease-management approach. In this proposal we will enrich this program by an intervention in which we provide the COPD-patient with computer-tailored feedback between consultations.



We will assess the feasibility of this intervention by conducting a pilot study in which we examine the effects on (1) patient self management and (2) the organization of care; (3) the use and appreciation of the information technology; (4) the costs and benefits of a full implementation. The study has a pre-post design with process measurement during the intervention. We recruit 48 COPD-patients equally divided over 4 general practitioners. Main outcome measures are (1) the observed levels of self management and use of information technology; (2) the perceived benefits for care, self-management, and organization; (3) the estimated costs and benefits of a full implementation. Data sampling takes place by a web-based questionnaire, physician consultation, information-system logging, in-depth interviews, and focus groups. Within the pilot we conduct a small experiment to compare different frequencies to remind the patient to revisit the computer-tailoring system. For this experiment we use a balanced-block design with three blocks of four patients per general practitioner. At the end of the project the results are commented by an expert panel and recommendations are given about the optimization of the EPR infrastructure.

Does computer tailored feedback improve the lifestyle of COPD patient?

1 year.

The self help manager is a computer program that provides the patient with feedback. The patient will fill in a questionnaire and the responses to the questions will yield a specific advice.