Dating with copd employers mandating vaccinations

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The allocation was made using a web-based programme hosted by the Primary Care Clinical Research and Trials Unit, University of Birmingham.

Centre specific randomisation lists were produced by a statistician at the trials unit.

After informed consent, post-bronchodilator spirometry was undertaken, height and weight were measured, and the patient was asked to complete a baseline questionnaire pack.

This questionnaire pack included questions on patient demographics and the measures for the primary and secondary outcomes.

Objective To evaluate the effectiveness of telephone health coaching delivered by a nurse to support self management in a primary care population with mild symptoms of chronic obstructive pulmonary disease (COPD).

Key techniques include modelling behaviour, goal setting, and empowering the patient to improve their health status.4 Telephone health coaching has shown potential benefits on self efficacy, health behaviour, and health status in a rapid review of trials in long term conditions.5COPD is a common respiratory condition with an estimated 65 million people worldwide with moderate or severe disease.1 Like most chronic diseases, it causes a considerable burden on health services and society and is a leading cause of death in most countries.67 Interventions to support self management in patients with COPD have been shown to be effective in improving health related quality of life and in reducing hospital admissions among patients with COPD,89 but trials have largely recruited people from secondary care and excluded those with mild disease.9 However, patients with mild dyspnoea represent 38% to 54% of diagnosed patients in primary care.1011 This is likely to increase with case finding initiatives to identify disease in people with symptoms.12Many components of self management interventions could promote better health and prevent disease progression in the early stages of COPD.

The usual care group received a standard information leaflet about self management of COPD.25 The 13 page leaflet gave a definition of COPD, a detailed description of associated symptoms, how the illness can be managed with the use of inhalers, how to treat exacerbations, and details of other resources (eg, British Lung Foundation and NHS Smokefree).

The intervention consisted of telephone health coaching delivered by a nurse with supporting written documents, a pedometer, and a self monitoring diary.

However, more recent efforts have aimed to prevent onset or slow progression early in the disease course to reduce the burden and costs of treating more advanced disease later.

This prevention model has only recently been adopted in COPD, with calls for interventions to reduce risk in people with early disease.3The growing number of people at risk of developing long term conditions and the prevalence of early disease, means an accessible and low resource approach needs to be taken to support self management.

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