Li Na, Wang Wenjing, Lv Yinyin, Li Caihong, Mu Xiangdong
Department of Nursing, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua Medicine, Tsinghua University, Beijing, People's Republic of China.
School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China.
Int J Chron Obstruct Pulmon Dis. 2025 May 8;20:1407-1417. doi: 10.2147/COPD.S517564. eCollection 2025.
This study aims to investigate the effects of case management on elderly patients with chronic obstructive pulmonary disease (COPD) and compare changes in pulmonary function indicators, quality of life, dyspnea, and inhaled medication adherence before and after case management.
A total of 199 elderly COPD patients were enrolled from Beijing Tsinghua Changgung Hospital between January 2020 and November 2023. We implemented case management programs including regular patient education, personalized interventions, continuous support systems, and timely feedback mechanisms, and subsequently collected patient data at 1, 3, 6, and 12 months after initiating case management.
After one year of case management, pulmonary function indicators (FEV/FVC, FEV, FEV%pred, MMEF75/25 and MMEF75/25%) in elderly patients with COPD showed significant improvement (P < 0.001). The CAT score decreased from 17.96±6.57 (mean ± standard deviation) to 11.80±6.50, and mMRC score decreased from 2.35±0.66 to 1.14±0.92 (p<0.001). Additionally, 77.9% (155/199) of patients were able to maintain their use of the inhaler for 1 year.
This study confirmed the significant role of case management in improving respiratory function, quality of life, and dyspnea in elderly patients with COPD. These findings not only provide a valuable reference for clinicians and patients, but also provide a strong foundation for further optimization of management strategies for elderly patients with COPD.
本研究旨在探讨病例管理对老年慢性阻塞性肺疾病(COPD)患者的影响,并比较病例管理前后肺功能指标、生活质量、呼吸困难及吸入药物依从性的变化。
2020年1月至2023年11月期间,从北京清华长庚医院招募了199例老年COPD患者。我们实施了病例管理计划,包括定期患者教育、个性化干预、持续支持系统和及时反馈机制,并在启动病例管理后的1、3、6和12个月收集患者数据。
经过一年的病例管理,老年COPD患者的肺功能指标(FEV/FVC、FEV、FEV%pred、MMEF75/25和MMEF75/25%)有显著改善(P<0.001)。CAT评分从17.96±6.57(均值±标准差)降至11.80±6.50,mMRC评分从2.35±0.66降至1.14±0.92(p<0.001)。此外,77.9%(155/199)的患者能够持续使用吸入器1年。
本研究证实了病例管理在改善老年COPD患者呼吸功能、生活质量和呼吸困难方面的重要作用。这些发现不仅为临床医生和患者提供了有价值的参考,也为进一步优化老年COPD患者的管理策略奠定了坚实基础。