Researchers at the University of Florida and University of Pennsylvania recently reported a successful web-based communication method for the identification of relevant care coordination topics in chronic obstructive pulmonary disease (COPD) based on a panel of individuals including the medical, scientific and patient community. The study was published in the journal JMIR Research Protocols and is entitled “Evaluating Comparative Effectiveness Research Priorities for Care Coordination in Chronic Obstructive Pulmonary Disease: A Community-Based eDelphi Study.”
COPD is one of the most common lung diseases and a major cause of morbidity and mortality worldwide, being the third leading cause of death in the United States. It is a progressive disease in which individuals develop serious problems in breathing with obstruction of the airways, shortness of breath (dyspnea), cough and acute exacerbations. Smoking is considered to be the leading cause of COPD and the disease can seriously impact the patient’s physical capacity, well-being and social functioning.
COPD has a high economic burden in the United States, especially because of a poor management of the comorbidities often associated with the disease, such as heart disease, hypertension and mental illness. Effective care coordination strategies to help patients manage their condition are essential to provide the most benefit to patients with the least possible harm, and also to reduce costs associated with the disease.
In the study, researchers evaluated the most relevant COPD care coordination strategies based on the input from the community, especially from medically underserved populations. The team used a simple, user-friendly web-based platform to survey comparative effectiveness research ideas, problems, priorities and hypotheses in COPD care coordination among clinicians, research scientists, informal caregivers and medically underserved COPD patients. Examples of care coordination strategies in COPD include smoking cessation, pulmonary rehabilitation, influenza and pneumonia vaccination and pharmacotherapies.
The team used the eDelphi method, a structured method that relies on a panel of experts, and conducted three rounds of web-based surveys. In the first two rounds, 37 panelists visualized a series of “mini research prospectus” YouTube video presentations and classified the importance of ten COPD care coordination topics. At the end of these two rounds, the eight favorite topics were ranked and commented on a third round by the panelists. At the end of the process, panelists also provided feedback regarding the potential impact of a web-based engagement network aiming at improving the comparative effectiveness research in COPD.
Researchers found that the care coordination topics considered the most important were: measurement of quality of care, management of COPD with other chronic health issues, pulmonary rehabilitation as a model for care, quality of care and comprehensive COPD patient education. The panelists reported that it was important to compare the different care strategies for COPD management and assess new methods of patient-provider communication. In total, 51% of the virtual panelists believed that a web-based engagement network could allow more online community meetings, and 49% believed that it could facilitate and create more opportunities for the medical, scientific and especially the general community to suggest, provide feedback or vote on new comparative effectiveness research ideas.
The research team concluded that through a virtual advisory board using a structured web-based communication method was possible to identify the most relevant community-specific COPD care coordination research topics and questions. The authors believe that there is a need for more comparative effectiveness research studies that assess quality of care parameters related to treatment and intervention among medically underserved COPD patients, and emphasize the importance of involving patients and informal caregivers in this process.
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