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Moderator: Dr P R Deshmukh Presenter: Dr Himani

Community based integrated intervention for prevention and management of Chronic O bstructive Pulmonary Disease in Guangdong, China: cluster randomised controlled trial Zhou Y et al BMJ 2010; 341. Moderator: Dr P R Deshmukh Presenter: Dr Himani. Introduction.

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Moderator: Dr P R Deshmukh Presenter: Dr Himani

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  1. Community based integrated intervention for prevention and management of Chronic Obstructive Pulmonary Disease in Guangdong, China: cluster randomised controlled trialZhou Y et alBMJ 2010; 341 Moderator: Dr P R Deshmukh Presenter: Dr Himani

  2. Introduction • COPD has become a major public health problem worldwide • Current interventions are carried out in hospital • Little attention has been paid to community based integrated interventions for earlier stages of disease

  3. Objective of study : To evaluate the effects of community based integrated intervention for early prevention and management of chronic obstructive pulmonary disease (COPD) in China Learning Objective: To learn about analysis of RCT

  4. Methodology • Study Area: Guangzhou city, China • Study duration: September 2002 to May 2007 • Study Population: All participants aged 40-89 years • Exclusion criteria- Diagnosis with active Tuberculosis, asthma or bronchiectasis, cystic fibrosis, interstitial lung disease, or pulmonary thromboembolic disease, malignant tumor, history of thoracotomy with pulmonary resection • Study Design: Cluster Randomised Trial

  5. Sample Size: N= 2(Zα+Zβ)2 (SD)2 * δ (µ1-µ2)2 (µ1-µ2) = Mean difference = 20 SD= standard deviation = 80 δ = design effect = 2.2 δ= 1+(m-1)ρ, m=cluster size, ρ= intracluster correlation coefficient N= 1102

  6. Flowchart for methodology

  7. Components and timings of Integrated Intervention

  8. Table1: Baseline characteristics within health care units

  9. Table 2: Baseline Characteristics of participants randomly selected from 2 communities

  10. Table 2 cont…

  11. Table 2 cont…

  12. Table3: Difference between two communities in annual rate of decline in FEV1, FEV1/FVC

  13. Table 4: Awareness of health knowledge, change of risk factors, cumulative incidence rate, and case death rate between two communities after intervention

  14. Table 4 cont…

  15. Table 4 cont…

  16. Discussion

  17. Conclusion • This community based integrated intervention helped to prevent and control COPD through improved awareness of COPD, reduced risk factors for COPD, and a reduction of rate of decline in FEV1

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