11
views
0
recommends
+1 Recommend
1 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Programas educativos en pacientes con Enfermedad Pulmonar Obstructiva Crónica. Revisión integradora Translated title: Educational programs for patients with Chronic Obstructive Pulmonary Disease. Integrative Review

      review-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Resumen Según la OMS, el objetivo de la educación terapéutica (ET) es ayudar al paciente a adquirir los recursos necesarios para gestionar óptimamente su vida con una enfermedad crónica. La ET forma parte del tratamiento en la prevención secundaria y terciaria. La última revisión de la Cochrane ha demostrado resultados positivos, sin embargo, la heterogeneidad de las poblaciones, tipo de intervenciones y medidas de resultado hace que sea difícil establecer recomendaciones claras en este ámbito. Así como se desconoce qué instrumentos son los recomendables para evaluar el cumplimiento terapéutico en la EPOC. Por tanto es necesario realizar de una revisión con el objetivo de conocer las características de los ensayos clínicos, el perfil del paciente EPOC, los contenidos de la ET y las variables estudiadas en los mismos. Identificándose 22 ensayos clínicos con una alta calidad metodológica, escala Jadad >3 que mostraron que en los ensayos clínicos de programas de ET las variables más estudiadas son la calidad de vida, ingresos hospitalarios y las variables de función pulmonar, donde la ET disminuye los ingresos hospitalarios, favorece la deshabituación tabáquica, mejora los conocimientos de la EPOC cuyas intervenciones son sesiones grupales, con diferentes materiales educativos, existiendo un auge en el número de publicaciones en este ámbito. Existe una gran variedad en los instrumentos de evaluación y heterogeneidad de las intervenciones, para establecer conclusiones.

          Translated abstract

          Abstract According to WHO, the aim of therapeutic education (TE) is help the patient to acquire the resources necessary to optimally manage your life with a chronic disease. The TE is part of treatment in secondary and tertiary prevention. The latest Cochrane review has shown positive results however, heterogeneity of populations, types of interventions and outcome measures makes it difficult to establish clear recommendations in this area. And what instruments are recommended to assess the therapeutic education in patients with COPD. It is therefore necessary a review with the aim of knowing the characteristics of clinical trials, the profile of COPD patient, the contents of ET and the variables studied in them. In this review are Identified 22 clinical trials with high methodological quality, Jadad scale> 3. Which showed that in clinical trials programs ET the most studied variables are the quality of life, hospital admissions and lung function variables, where ET decreases hospital admissions, promotes smoking cessation and improving knowledge of COPD. Whose interventions are group sessions with different educational materials. There being a rise in the number of publications in this area, there is a great variety of assessment tools and heterogeneity of interventions, to draw conclusions.

          Related collections

          Most cited references89

          • Record: found
          • Abstract: not found
          • Article: not found

          Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015: elaboration and explanation

            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Integrated care prevents hospitalisations for exacerbations in COPD patients.

            Hospital admissions due to chronic obstructive pulmonary disease (COPD) exacerbations have a major impact on the disease evolution and costs. The current authors postulated that a simple and well-standardised, low-intensity integrated care intervention can be effective to prevent such hospitalisations. Therefore, 155 exacerbated COPD patients (17% females) were recruited after hospital discharge from centres in Barcelona (Spain) and Leuven (Belgium). They were randomly assigned to either integrated care (IC; n = 65; age mean+/-sd 70+/-9 yrs; forced expiratory volume in one second (FEV(1)) 1.1+/-0.5 L, 43% predicted) or usual care (UC; n = 90; age 72+/-9 yrs; FEV(1) 1.1+/-0.05 L, 41% pred). The IC intervention consisted of an individually tailored care plan upon discharge shared with the primary care team, as well as accessibility to a specialised nurse case manager through a web-based call centre. After 12 months' follow-up, IC showed a lower hospitalisation rate (1.5+/-2.6 versus 2.1+/-3.1) and a higher percentage of patients without re-admissions (49 versus 31%) than UC without differences in mortality (19 versus 16%, respectively). In conclusion, this trial demonstrates that a standardised integrated care intervention, based on shared care arrangements among different levels of the system with support of information technologies, effectively prevents hospitalisations for exacerbations in chronic obstructive pulmonary disease patients.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              A comprehensive care management program to prevent chronic obstructive pulmonary disease hospitalizations: a randomized, controlled trial.

              Improving a patient's ability to self-monitor and manage changes in chronic obstructive pulmonary disease (COPD) symptoms may improve outcomes. To determine the efficacy of a comprehensive care management program (CCMP) in reducing the risk for COPD hospitalization. A randomized, controlled trial comparing CCMP with guideline-based usual care. (ClinicalTrials.gov registration number: NCT00395083) SETTING: 20 Veterans Affairs hospital-based outpatient clinics. Patients hospitalized for COPD in the past year. The CCMP included COPD education during 4 individual sessions and 1 group session, an action plan for identification and treatment of exacerbations, and scheduled proactive telephone calls for case management. Patients in both the intervention and usual care groups received a COPD informational booklet; their primary care providers received a copy of COPD guidelines and were advised to manage their patients according to these guidelines. Patients were randomly assigned, stratifying by site based on random, permuted blocks of variable size. The primary outcome was time to first COPD hospitalization. Staff blinded to study group performed telephone-based assessment of COPD exacerbations and hospitalizations, and all hospitalizations were blindly adjudicated. Secondary outcomes included non-COPD health care use, all-cause mortality, health-related quality of life, patient satisfaction, disease knowledge, and self-efficacy. Of the eligible patients, 209 were randomly assigned to the intervention group and 217 to the usual care group. Citing serious safety concerns, the data monitoring committee terminated the intervention before the trial's planned completion after 426 (44%) of the planned total of 960 patients were enrolled. Mean follow-up was 250 days. When the study was stopped, the 1-year cumulative incidence of COPD-related hospitalization was 27% in the intervention group and 24% in the usual care group (hazard ratio, 1.13 [95% CI, 0.70 to 1.80]; P= 0.62). There were 28 deaths from all causes in the intervention group versus 10 in the usual care group (hazard ratio, 3.00 [CI, 1.46 to 6.17]; P= 0.003). Cause could be assigned in 27 (71%) deaths. Deaths due to COPD accounted for the largest difference: 10 in the intervention group versus 3 in the usual care group (hazard ratio, 3.60 [CI, 0.99 to 13.08]; P= 0.053). Available data could not fully explain the excess mortality in the intervention group. Ability to assess the quality of the educational sessions provided by the case managers was limited. A CCMP in patients with severe COPD had not decreased COPD-related hospitalizations when the trial was stopped prematurely. The CCMP was associated with unanticipated excess mortality, results that differ markedly from similar previous trials. A data monitoring committee should be considered in the design of clinical trials involving behavioral interventions.
                Bookmark

                Author and article information

                Journal
                eg
                Enfermería Global
                Enferm. glob.
                Universidad de Murcia (Murcia, Murcia, Spain )
                1695-6141
                2017
                : 16
                : 45
                : 537-573
                Affiliations
                [1] Castellón de la Plana Valencia orgnameUniversitat Jaume I Spain afolch@ 123456uji.es
                [3] Barcelona orgnameHospital Clinic España
                [2] Valencia orgnameUniversidad de Alicante Spain
                Article
                S1695-61412017000100537 S1695-6141(17)01604500537
                10.6018/eglobal.16.1.249621
                fa807fb9-cb3b-443a-a067-17904d92e0b1

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 International License.

                History
                : 15 April 2016
                : 27 January 2016
                Page count
                Figures: 0, Tables: 0, Equations: 0, References: 89, Pages: 37
                Product

                SciELO Spain

                Categories
                Revisiones

                nursing health education,COPD,EPOC,educación en salud
                nursing health education, COPD, EPOC, educación en salud

                Comments

                Comment on this article