Original Article
Study on the correlation between health education compliance and treatment outcome of chronic obstructive pulmonary disease
Xiaowei Cao, Hao Chang, Bo Sun, Jun Cao, Yanxue Wang, Peng Zhou, Shuzheng Cui, Zhijie Xia
Published 2017-10-20
Cite as Chin J Health Manage, 2017, 11(5): 446-452. DOI: 10.3760/cma.j.issn.1674-0815.2017.05.009
Abstract
ObjectiveTo explore the influence of health education and treatment compliance on COPD patients' outcome.
Methods258 subjects (186 males, 72 females, average age 75.2±8.5 years) were enrolled from patients diagnosed with COPD between June 2013 to June 2014 in huashan hospital north compus. Study began in July 2014, health condition assessment and grading、telephone follow-up and education were performed once every half a year together with COPD lectures, the number of patients participated in education sessions, and status of smoking cessation, exercise\home oxygen therapy and medication were recorded as indicators for health education compliance. Clinic/hospital stay and cost, condition change were also recorded. The study ended in December 2015 with final assessments of conditions and classification of patient outcome. Multiple logistic regression was used to analyze factors influencing the COPD patient's outcome; Independent sample t test was applied to compare different compliance in patients with outpatient and hospitalization per-time cost difference.
ResultsHigher reimbursement ratio, the better adherence for health education, no complications and the low grade of disease classification at the beginning of the study were protective factors (OR=10.35, 2.147, 5.791, 4.51, P< 0.05); Underweight to normal weight, 5 times or more acute attacks during during the study, poor health education compliance were risk factors for disease progression (OR=0.031, 0.131, 0.010, P< 0.05); Never exercise and never participating in health education management are the risk of illness/death((OR=6.793, P=0.005, 95% CI: 1.766~26.125) vs.(OR=11.872, P=0.002, 95% CI: 2.525~55.815)); for mild COPD patients, these never participating in health education management had a higher per hospitalization than patients with health education management (6 619 yuan, t= 2.681, P= 0.010). The outpatient cost of more severe COPD patients who are smoking or quitted smoking in less than 5 years was higher than these quitted smoking more than 5 years (985 yuan, t=-2.225, P= 0.028).
ConclusionsHealth education management can help medical staff to provide guidance to patients to quit smoking, encouraging the regular use of home oxygen therapy, doing more exercise, taking prescription of preventive drugs, these will in turn improve patient compliance for disease control and prevention. These efforts can effectively slow disease progression and improve patient outcomes, reduce medical costs, reduce the burden of the family and society.
Key words:
Lung diseases, obstructive; Health education; Compliance; Prognosis
Contributor Information
Xiaowei Cao
Huashan Hospital North Affiliated to Fudan University, Department of Emergency Medicine and Critical Care Medicine, Shanghai 201907, China
Hao Chang
Department of Medical Examination, Shanghai 201907, China
Bo Sun
Huashan Hospital North Affiliated to Fudan University, Department of Emergency Medicine and Critical Care Medicine, Shanghai 201907, China
Jun Cao
Huashan Hospital North Affiliated to Fudan University, Department of Emergency Medicine and Critical Care Medicine, Shanghai 201907, China
Yanxue Wang
Huashan Hospital North Affiliated to Fudan University, Department of Emergency Medicine and Critical Care Medicine, Shanghai 201907, China
Peng Zhou
Department of Outpatient Office, Shanghai 201907, China
Shuzheng Cui
Department of Medical Affairs, Shanghai 201907, China
Zhijie Xia
Huashan Hospital North Affiliated to Fudan University, Department of Emergency Medicine and Critical Care Medicine, Shanghai 201907, China