Kanniess F, Krockenberger K, Oepen P, Hedrich R, Olbrich D, Hessler N, Ziegler A, Langer-Brauburger B
Gemeinschaftspraxis Reinfeld, Reinfeld.
Current affiliation: AMEDON GmbH, Lübeck.
Pneumologie. 2020 Mar;74(3):174-182. doi: 10.1055/a-0978-1079. Epub 2020 Mar 6.
The efficacy of the German disease management programs (DMP) asthma and chronic obstructive pulmonary disease (COPD) cannot be shown with the legally bound documentations. Studies with control groups are rare. Aim of this work was to investigate in a cross-sectional study whether the disease control differs in participants (DMP+) and non-participants (DMP - ) of the DMPs asthma and COPD.
The study was a prospective multicenter cross-sectional study. Primary endpoints were the Asthma Control Test™ (ACT) in the asthma part of the study and the COPD Assessment Test™ (CAT) for the COPD part.
A total of 1038 asthma patients and 846 COPD patients were included, of whom about 70 % participated in the corresponding DMP. The ACT total score was higher in asthma DMP+ patients than in DMP- patients (mean difference 0.86; 95 % CI: 0.29 - 1.43;p = 0.003), but not clinically relevant. For COPD there was no clinically relevant difference in COPD disease impact (0.52; 95 % CI: - 0.71 - 1.75; p = 0.405). Although DMP patients had to be enrolled in the respective DMP for at least one year, only 60 % of these patients had participated in a structured education. We did not observe a difference in disease control in DMP patients who respectively participated and did not participate in a structured education.
There was no clinically relevant difference in disease control between DMP+ and DMP- patients. The efficacy of DMPs has been demonstrated internationally in randomized controlled trials. Randomized controlled trials should be conducted in Germany for demonstrating efficacy of DMPs asthma and COPD.
drks.de, DRKS00007664, Registration date: Jan 15, 2015.
德国疾病管理项目（DMP）中哮喘和慢性阻塞性肺疾病（COPD）的疗效无法通过法定文件证明。有对照组的研究很少。这项工作的目的是在一项横断面研究中调查哮喘和COPD疾病管理项目的参与者（DMP+）和非参与者（DMP-）的疾病控制情况是否不同。
该研究是一项前瞻性多中心横断面研究。主要终点是研究中哮喘部分的哮喘控制测试™（ACT）和COPD部分的COPD评估测试™（CAT）。
共纳入1038例哮喘患者和846例COPD患者，其中约70%参与了相应的疾病管理项目。哮喘DMP+患者的ACT总分高于DMP-患者（平均差异0.86；95%CI：0.29 - 1.43；p = 0.003），但无临床相关性。对于COPD，COPD疾病影响方面无临床相关差异（0.52；95%CI：- 0.71 - 1.75；p = 0.405）。尽管疾病管理项目患者必须至少参加各自的疾病管理项目一年，但这些患者中只有60%参加了结构化教育。我们没有观察到分别参加和未参加结构化教育的疾病管理项目患者在疾病控制方面的差异。
DMP+和DMP-患者在疾病控制方面无临床相关差异。疾病管理项目的疗效已在国际上的随机对照试验中得到证实。德国应进行随机对照试验以证明哮喘和COPD疾病管理项目的疗效。
drks.de，DRKS00007664，注册日期：2015年1月15日。
