Extrait

Background and study aims We are carrying out a study for strengthening the delivery of asthma and chronic obstructive pulmonary disease (COPD) care at primary health care (PHC) facilities already supporting tuberculosis (TB) care in Pakistan. The aim is to deliver quality asthma and COPD care through primary health care facilities in Pakistan. Who can participate? The eligible asthma and COPD patients of both genders, aged eighteen and above in the catchment area of the given health facility will be recruited in the study. A total of 428 asthma and 306 COPD patients will be recruited . What does the study involve? The proposed study will help to improve access to and quality of care for common lung health conditions, especially in underserved population i.e. rural areas. This will be done mainly by developing, testing and refining packages of essential curative and preventive services for asthma and COPD, through primary health care. This covers both the delivery and management support dimensions of quality care. We will compare the control of asthma and COPD achieved in the patients receiving quality lung health care (i.e. using standardised evidence-based guideline and materials) in comparison with the disease control for those receiving routine care at the PHC facilities. The asthma control and COPD control will be measured at baseline (beginning of the study) and 6 and 12 months after the start of treatment. The proposed research on care of asthma and COPD conditions will cover: a) enhanced screening and diagnosis, b) standardized prescription, c) interactive education of patient and family, d) follow-up and adherence, e) referral linkage with respective district hospital, f) district health office engagement and support, and g) technical support for in-country research uptake. What are the possible benefits and risks of participating? Participants: Free diagnosis and treatment as per standardized clinical guidelines: Though routine drugs for the asthma and COPD are mentioned in the Drug list of the primary health care facilities - Rural Health Centre (RHC), they are not always present given the scarce resource setting. RHCs will be strengthened in this reference, to an extent possible, in the intervention arm. The control arm patients will receive the current best practice, whereas intervention arm will receive enhanced care. Only nationally approved diagnostic and drugs will be used. The trial protocols will not expose patients to any additional risk. Society: Two districts with an estimated population of 2.5 million living in rural and semi-urban localities [including 18 RHCs and Tehsil headquarter hospitals (THQs)] will be enabled to manage and sustain quality care for asthma and COPD. These services will continue even after the trial, through respective district health office and potentially benefit thousands of diabetics in the district. At least 214 asthma and 153 COPD cases (in the intervention arm) will receive enhanced lung care. A set of case management desk guide, training package, patient education materials, and recording/reporting/monitoring system for lung health care will be potentially used in all 135 districts of Pakistan: Sound scientific evidence for programmatic decision making in Pakistan (and elsewhere). There are no adverse effects of the trial itself but there may be expected side effects of certain drugs that are used in the Asthma- COPD management package. To decrease this risk to the minimal only approved drugs will be used. The trial protocols will not expose patients to any additional risk. Where is the study run from? The study will run from 18 rural health centres (RHCs) and sub-district hospitals in districts Rawalpindi and Islamabad. When is the study starting and how long is it expected to run for? October 2012 to December 2016. Who is funding the study? The study is funded by COMDIS Health Service Delivery Research Programme Consortium (COMDIS-HSD), The University of Leeds UK and is being implemented by Association for Social Development in Pakistan. Who is the main contact? Dr. Muhammad Amir Khan [email protected]

Critère d'inclusion

• Asthma and chronic obstructive pulmonary disease (COPD)

Liens

• ictrp
• isrctn