Care co-ordination among patients with Chronic Obstructive Pulmonary Disorder (COPD) is one of the most important goals in maintaining patient health as far as primary care is concerned. COPD is the third leading cause of death in the United States, with an overall economic burden of approximately $50 billion, most of which is due to lack of care co-ordination among patients with COPD and other co-morbidities. Research has been conducted on different strategies to ensure proper care co-ordination among patients, but a comprehensive, comparative effectiveness research (CER) study comparing these different strategies is necessary to increase the effectiveness of such measures.
A recently published study executed by scientists and researchers at the University of Florida and the University of Pennsylvania evaluated the efficacy of CER in care co-ordination for COPD patients using the Delphi method by receiving input from an expert panel that included patients who received lesser medical attention than deserved; the less economically fortunate and those with a lower level of computer literacy; informal care-givers; physicians and research scientists, all of whom served as community based stakeholders according to the study model. A total of three iterative rounds of web-based surveys were carried out – the first two of these involved reviewing a set of 10 topics related to COPD care co-ordination with the help of You Tube videos that depicted a “mini research prospectus” for each topic. These topics were then graded using 7 point Likert scales. The third round was based on focussing and commenting on the remaining 8 most popular topics favored by the panelists in the first two rounds. Following this, the panelists were asked to provide their valuable feedback regarding this system of conducting web-based surveys involving stakeholder networks for improved COPD care co-ordination and CER.
Results based on rankings from panelists showed that the most important points to improve COPD care co-ordination were measurement of quality of care, management of COPD with other chronic health, pulmonary rehabilitation as a model for care for COPD patients, quality of care coordination, and comprehensive COPD patient education. The need to improve management of COPD symptoms and improving patient-provider relationships were also stressed by the community-based stakeholders and panelists. It was noted that around one half of the 37 member virtual advisory board were observed engaging in online discussions, online community meetings and commenting and suggesting upon new ideas for CER and COPD management. As a result, this web based discussion forum was successful in addressing the unmet medical needs of underserved patients with COPD and also highlighted the need for more of such sessions of CER.