UPDATE – 05 October, 2016: Another story about this award-winning research project was published in the Amherstburg River Town Times.
Windsor Star article published on September 7, 2016. Article in full pasted below.
Brian Cross, Windsor Star
*Note: The study cited in this article was conducted across a partnership of 6 FHTs in the Erie St. Clair LHIN region: Amherstburg, Windsor, Harrow Health Centre, Leamington & Area, Tilbury District, and Chatham-Kent, although the article mentions only Amherstburg. AFHTO extends congratulations to all of the participating teams.
An innovative team approach to caring for local lung disease patients improved their quality of life so tremendously it’s receiving international recognition.
“Huge, impressive, substantial,” are words London academic respirologist Dr. Chris Licskai uses to describe the results of the local study he was involved with, along with physicians and respiratory therapists from family health teams in Windsor-Essex and Chatham-Kent.
The study proves that proactively caring for these chronic obstructive pulmonary disease (COPD) patients before they become acutely unwell and teaching them to manage their own illness reverses their downward spiral.
Licskai said patients who suffered on a daily basis from wheezing, coughing and shortness of breath so severe they couldn’t do such simple activities as walk from room to room, climb stairs or get dressed, improved to the point they experienced symptoms only a couple of times a week.
“The tremendous finding here was that the patients’ quality of life substantially improved,” Amherstburg family doctor Dr. Tim O’Callahan said this week from London, England, where he, Licskai and lead educator Madonna Ferrone presented their research to the European Respiratory Society meeting, the largest respiratory conference in the world.
The society was so impressed that the group’s paper was chosen the best primary care research paper and will be published in the Primary Care Respiratory Care Medicine Journal.
O’Callahan said health professionals at family health teams wanted to try a new approach to caring for COPD patients — who make up about 12 per cent of their practice. An estimated 850,000 Ontarians have COPD, which includes such chronic, incurable illnesses as emphysema. COPD is most often caused by smoking.
“It’s a very common problem in our patients in primary care and it has a major impact on their quality of life,” said O’Callahan, who works at the Amherstburg Family Health Team.
The group took a total of their 181 worst-off COPD patients and divided them into two groups: one group received the kind of care they’d always received from their family doctor, and the other received “collaborative self management.”
This involved sit-down sessions with respiratory therapists to get detailed assessments, to learn about their disease and to devise an action plan so the patient knew what to do when symptoms worsened.
The action plan often included getting prescriptions filled ahead of time for antibiotics and the steroid pregnizone. In the event of a flareup of symptoms, they treated themselves immediately, avoiding the wait to get in to see their doctor, which can sometimes delay treatment by several days or a week.
Doctors were regularly brought in to the meetings to consult on changes. Patients learned to recognize when their symptoms were getting out of control and what to do.
“We worked on making the patient the expert in their own disease,” said Ferrone, who said she was “completely amazed by the results.”
Every three months, patients in both groups were given a COPD assessment test that measures quality of life. The CAT score runs from zero (no impairment) to 40 (completely impaired). The patients in the collaborative self-management group had an average score of 22 when they started and dropped down to 15 in the course of a year. The control group receiving regular care started with a score of 19 and worsened to 22.
“Improvement of over three is considered significant and patients in our study increased by seven,” O’Callahan said.
Collaborative self management also reduced urgent visits to the doctor by 67 per cent. Trips to the hospital emergency also dropped by 67 per cent.
That means that the extra cost of providing COPD patients with collaborative self management is more than offset by the money saved, said O’Callahan.
“We can reduce costs and improve quality of life, so it’s all good, all the way around.”
The local group was initially turned down for funding from the Ministry of Health and relied on money from pharmaceutical companies. But the early results proved so promising that the ministry changed its mind and provided funding, O’Callahan said.
Now, the researchers believe the evidence justifies expanding the program to many more people suffering from COPD, beyond the family health teams.
“I’m hoping that our study will contribute to practise change in Canada and perhaps beyond Canada, in a way that will have a longstanding impact on patients with COPD,” said Licskai.
For info on the participating teams, visit: