R. William Vandivier, MD; Derek J. Linderman, MD; Patricia B. Koff, RRT, Med
Potential Conflicts of Interest: Dr. Vandivier: Grant (money to institution): Colorado Department of Public Health and Environment, University of Colorado Hospital. Dr. Koff: Grant (money to institution): State of Colorado; Consulting fee or honorarium: Nonin Medical, Connections 365, Robert Bosch Healthcare; Support for travel to meetings for the study or other purposes (money to institution): State of Colorado; Fees for participation in review activities such as data monitoring, boards, statistical analysis, end point committees, and the like (money to institution): State of Colorado; Provision of writing assistance, medicines, equipment, or administrative support (money to institution): grant supported administrative assistant, Datex-Ohmeda, Health Hero Network; Consultancy: Nonin Medical, Connections 365, Robert Bosch Healthcare; Employment: Robert Bosch Healthcare.
Vandivier R., Linderman D., Koff P.; A Comprehensive Care Management Program to Prevent Chronic Obstructive Pulmonary Disease Hospitalizations. Ann Intern Med. 2012;157:530. doi: 10.7326/0003-4819-157-7-201210020-00018
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Published: Ann Intern Med. 2012;157(7):530.
TO THE EDITOR:
We were disappointed at the results of a comprehensive care management program for chronic obstructive pulmonary disease (COPD) reported by Fan and colleagues (1). Patients received extensive education and were given an individualized action plan that advised them to initiate therapy within 48 hours of symptom onset and to contact their care coordinator if it was not effective. The intervention had minimal to no effect on treatment and worsened mortality rates. As pointed out in the article, treatment delays are common in patients with COPD, and these delays result in worse clinical outcomes (1). We would be interested to know how many patients contacted coordinators at symptom onset and whether they contacted coordinators as directed when symptoms worsened or became persistent.
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