The effect of a respiratory home nurse intervention in patients with chronic obstructive pulmonary disease (COPD)

Brian J. Smith, Sarah Appleton, P. W. Bennett, G. C. Roberts, P. Del Fante, Robert Adams, C. M. Trott, D. P. Allan, A. M. Southcott, R. E. Ruffin

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Background: Chronic obstructive pulmonary disease (COPD) is associated with substantial mortality, morbidity, and costs to the health care system. With the increasing interest in outreach care programmes it is important to evaluate their impact upon patients and health services, for conditions such as COPD. Aim: To determine the effectiveness of an outreach respiratory nurse in a shared care approach, with collaboration between general practitioners and hospital services, in the management of patients with severe COPD. Methods: Patients with severe COPD attending The Queen Elizabeth Hospital, Adelaide participated in a randomised controlled trial of a home based nursing intervention (HBNI) over 12 months with outcome measures including mortality rate, hospital service utilisation, FEV1 and health related quality of life (HRQL) using a modified Dartmouth Primary Care Co-operative Quality of Life questionnaire. Results: There were 48 subjects in each study arm, with no differences in mortality rate (eight deaths in the HBNI group and seven in the control group), hospital admissions, length of stay, number of outpatient and Emergency Service visits. The study had inadequate follow- up of FEV1 and HRQL within the control group. Within the HBNI group, a small improvement in HRQL (in three of ten indices measured) was demonstrated, despite a deterioration in FEV1 (11% reduction, p=0.04) compared to baseline. Quality of life of HBNI subjects' carers did not change. Conclusion: An increased level of care given by an outreach respiratory nurse in a shared care approach for patients with severe COPD produced small improvements in HRQL but did not result in the prevention of deaths or reduced health care utilisation.

Original languageEnglish
Pages (from-to)718-725
Number of pages8
JournalAustralian and New Zealand journal of medicine
Issue number5
Publication statusPublished - 1 Jan 1999
Externally publishedYes


  • Chronic obstructive pulmonary disease (COPD)
  • Nurse
  • Outreach
  • Respiratory health care worker

ASJC Scopus subject areas

  • Internal Medicine

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