ＣＯＰＤ発症前から地域単位でコントロールことで、肺機能改善

”community based integrated intervention for early prevention and management of chronic obstructive pulmonary disease (COPD) ”って、強制力が強そう・・・40-89歳の１０１名のＣＯＰＤと非ＣＯＰＤ７７１名を以下のプログラムに従って、プライマリアウトカムはＦＥＶ１の変化

ＣＯＰＤを集団的に系統的に発症前からコントロールしようというもの・・・中国ならではというより、日本も見習った方がよいのでは？

内容は・・・至極まっとうなもの

Components and timings of integrated intervention
All participants (healthy population, those at high risk of COPD, patients with COPD)

Systematic health education

* Items or components:
・Smoking hazards and instruction for smoking cessation
・ Knowledge of COPD and relative risk factors

* Scheme or timings:
・ Health manuals, bulletins, etc, in public places quarterly
・A lecture and a large scale free consultation twice a year
・A competition of knowledge and free spirometry annually

Participants at high risk of COPD, patients with COPD

Intensive and individualised interventions
* Items or components:
・Advice and instruction for smoking cessation
・Advice to improve air pollution and work environment
・Encouragement to exercise and improvement in living environment

*　Scheme or timing:
・A lecture, a club activity, and a visit quarterly in the first year and annually thereafter

Patients with COPD only

Treatment and rehabilitation
*　Items or components:
・Treatment with compound bronchodilator for a year
・Advice and guidance for individualised rehabilitation, drug use, and diet
・Questionnaire and spirometry quarterly in the first year and annually thereafter

*　Scheme or timing
・A visit each quarter in the first year for treatment with compound bronchodilator, advice, and guidance

結果・・

Community based integrated intervention for prevention and management of chronic obstructive pulmonary disease (COPD) in Guangdong, China: cluster randomised controlled trial
BMJ 2010; 341:c6387 doi: 10.1136/bmj.c6387 (Published 1 December 2010)
Cite this as: BMJ 2010; 341:c6387