Improved quality of care by using the PRISMS form to support self-management in patients with COPD: A Randomised Controlled Trial

Abstract

Aims and objective: To investigate the effects on the quality of care of the Patient Report Informing Self-Management Support (PRISMS) form compared with usual care among patients with chronic obstructive pulmonary disease (COPD) consulting a COPD nurse in primary health care.

Background: Patients with COPD experience symptoms affecting their everyday lives, and there is a need for interventions in self-management support. The delivery of chronic care in an organised, structured and planned manner can lead to more productive relationships between professionals and patients.

Design: A multicentre randomised controlled trial with a post-test design, according to the CONSORT checklist, in one intervention group (n = 94) and one control group (n = 108).

Methods: In addition to usual care, the intervention group (n = 94) completed the PRISMS form to indicate areas where they wanted self-management support before the consultation with the COPD nurse. This form comprises 17 items that patients with COPD commonly experience as problems. The control group received usual care (n = 108). The primary outcome was patients' satisfaction with quality of care, assessed using the Quality from the Patient's Perspective (QPP) questionnaire. Means and (SD) are presented where applicable. Differences between the intervention and control group were analysed with Student's t test for independent groups for interval data, and the Mann-Whitney U test for ordinal data.

Results: Participants in the intervention group were more satisfied with the QPP domains "personal attention," regarding both "perceived reality" (p = .021) and "subjective importance" (p = .012). The PRISMS form revealed "shortness of breath" as the most commonly experienced problem and the issue most desired to discuss.

Conclusion: The PRISMS form improved patient satisfaction with quality of care regarding personal attention, which is an important factor in patient participation and improving relationships and communication.

Relevance to clinical practice: The PRISMS form can be a useful tool in improving person-centred care when delivering self-management support.

Register id: 192691 at http://www.researchweb.org/is/en/sverige/project/192691.

Keywords: chronic obstructive pulmonary disease; nursing; patient education; primary care; quality of care; self-management support.