{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T10:50:39Z","timestamp":1777891839534,"version":"3.51.4"},"reference-count":41,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2014,11,4]],"date-time":"2014-11-04T00:00:00Z","timestamp":1415059200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Respir Care"],"published-print":{"date-parts":[[2015,1]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND:<\/jats:title>\n                    <jats:p>A number of effective strategies have been developed to improve the quality of life in patients with COPD. However, few have been implemented in patients with COPD at all stages in a community setting. This study evaluated the efficacy of a complex COPD health management intervention in rural communities in China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS:<\/jats:title>\n                    <jats:p>A randomized controlled trial including 8,217 subjects with COPD was implemented from May 2008 to May 2012 in 14 community health-care centers. The control group of subjects received usual care, whereas the management group of subjects participated in a health management program that included assessing the subjects' health status, giving regular health lectures, smoking cessation counseling, encouraging regular exercise, providing rehabilitative training and psychological counseling, and regular follow-up. As a primary outcome, we examined the changes in the BODE index. Secondary outcomes included depression and anxiety rates, current smoking rate, awareness of COPD, mortality, risk factors, respiratory medication use, hospital admissions, and emergency department visits.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS:<\/jats:title>\n                    <jats:p>\n                      After 4 y, the mean cumulative value of the BODE index increased by 0.7 per subject in the control group and decreased by 0.4 per subject in the health management group (difference of 1.1, 95% CI 0.2\u20132.0,\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .001). Health management reduced anxiety symptoms by 4.8%, depression symptoms by 6.6%, current smoking by 14.3%, mortality due to all causes by 9.0%, hospitalizations due to all causes by 16.1%, and emergency department visits due to all causes by 18.1% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05 for all). However, it increased immunomodulator use by 58.9%, respiratory medication use by 14.1\u201321.9%, and awareness scores for COPD by 57.2% (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; .05 for all).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSIONS:<\/jats:title>\n                    <jats:p>The health management program is an effective community-based strategy for the prevention and management of COPD in China, increasing awareness and knowledge among patients and practitioners and improving management within the limitations of access to pharmacotherapy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4187\/respcare.03420","type":"journal-article","created":{"date-parts":[[2014,11,4]],"date-time":"2014-11-04T23:55:20Z","timestamp":1415145320000},"page":"102-112","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":42,"title":["A COPD Health Management Program in a Community-Based Primary Care Setting: A Randomized Controlled Trial"],"prefix":"10.1177","volume":"60","author":[{"given":"Peian","family":"Lou","sequence":"first","affiliation":[{"name":"Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peipei","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiaxi","family":"Yu","sequence":"additional","affiliation":[{"name":"Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yong","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Na","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Li","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Control and Prevention of Chronic Non-communicable Diseases, Xuzhou Center for Disease Control and Prevention, Xuzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hongmin","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Affiliated Hospital of Xuzhou Medical College, Xuzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jing","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Affiliated Hospital of Xuzhou Medical College, Xuzhou, China."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2014,11,4]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61383-X"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1513\/pats.200701-017FM"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1378\/chest.10-1252"},{"issue":"4","key":"e_1_3_2_5_2","first-page":"475","article-title":"Meta-analysis of respiratory rehabilitation in chronic obstructive pulmonary disease. 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