Study On The Effect Of General Practitioner-specialist Comanagement In Patients With Stable Chronic Obstructive Pulmonary Disease

Objective:The general practice-specialty combination model was adopted in the patients of stable chronic obstructive pulmonary disease(COPD)and the efficacy had been studied for this research which aimed to optimize the existing management mode.Methods:120 COPD patients at stable phase were involved in the study from January 2019 to December 2019,6 months follow-up totally.After clinical treatment,the patient did not have acute respiratory failure and acute exacerbation.7 patients were excluded because they were lost to follow-up.113 patients divided into control group(n=55)and experimental group(n=58).The experimental group used practitioner-specialty combination model and adopted corresponding treatment pattern(Outpatient and family follow-up visits).Follow-up methods include telephone,wechat and questionnaire delivery.In control group,traditional outpatient treatment and and health education was used.We collected the information of general data,Bristol COPD Knowledge Questionnaire(BCKQ),the MOS 36-item Short From Health Survey(SF-36),COPD Assessment Test(CAT),modified British Medical Research council(m MRC),etc.Results:Intra group analysis was performed first.The control group was improved based on the comparative score of Bristol COPD Knowledge Questionnaire(BCKQ),COPD Assessment Test(CAT)and the physical functioning option in SF-36 at the follow up progression(P<0.05).Meanwhile,the knowledge of COPD for the patients about smoking,antibiotics,vaccines,inhaled bronchodilators and inhaled steroids in Bristol COPD Knowledge Questionnaire(BCKQ)were significantly increased(P<0.05);In experimental group,the Bristol COPD Knowledge Questionnaire(BCKQ)and COPD Assessment Test(CAT)were both improved and had statistically different(P<0.05).In the scoring options,we found the differences in epidemiology,etiology,sputum,exercise,smoking,antibiotics,vaccines,inhaled bronchodilators and inhaled steroids.There were statistical differences in scores of physical functioning,general health,social functioning,role-emotional and mental health of SF-36(P<0.05).Then,the two groups were compared,and we found that BCKQ in the experimental group which responded the knowledge of COPD for the patients was higher than that in the control group(P<0.05).There were significant differences in the scores of epidemiology,etiology,sputum,exercise,vaccine,inhaled bronchodilators and antibiotics in BCKQ,as well as the scores of physical functioning,general health and social functioning in the SF-36(P<0.05).The COPD Assessment Test(CAT)score of the test group was lower than that of the control group(P<0.05).Conclusion:Under the practitioner-specialist combination model with the participation and guidance of specialists,patients with stable COPD could effectively increase the knowledge of the disease and promote self-management capabilities,thus improve the mental state and quality of life.