TY - JOUR T1 - Disease Management Programs for Patients with chronic obstructive pulmonary disease in Germany – A longitudinal evaluation of routinely collected patient records JF - Respiratory Care DO - 10.4187/respcare.02748 SP - respcare.02748 AU - Michael Mehring AU - Ewan Donnachie AU - Johannes Fexer AU - Frank Hofmann AU - Antonius Schneider Y1 - 2013/11/12 UR - http://rc.rcjournal.com/content/early/2013/11/12/respcare.02748.abstract N2 - Introduction: The primary aim of the disease management program (DMP) for patients with COPD is to improve health outcomes and thereby to reduce overall costs. Six years after its introduction in Germany, no consensus has yet been reached as to whether the DMP has been effective in reaching these goals. Objective: Evaluation of the DMP for COPD in Bavaria using routinely collected subject medical records. Methods: A longitudinal population-based study, comparing the total DMP population of up to 86,560 patients with a stable cohort of 17,549 subjects over a period of five years. The effect of subject dropout in the cohort is further estimated by means of inverse probability weighting. Results: The proportion of subjects in the total population with prescribed oral corticosteroids declined at a constant rate of 1.0% per year (p>0.001). The proportion with prescription of theophylline decreased at a constant rate of 2.0% per year (p>0.001). By 2012, 15.6% of the total population and 26% of the cohort had undergone self-management education. While the proportion of smokers in the total population remained constant due the effect of newly enrolled subjects, the proportion of smokers decreased significantly even after dropout adjustment, from 29% to 21%. The occurrence of exacerbations decreased steadily at a rate of 0.9% (total population) or 0.7% (cohort) per year. While the occurrence of emergency admissions decreased in the total population, an increase was observed within the cohort Conclusions: Summarizing all results leads to the suggestion that the German DMP for COPD has been effective in enhancing the quality of care in regard to an improved adherence to guidelines, pharmacotherapy, exacerbations and self-management education. However, the DMP was not able to prevent an increase in emergency admissions for stable population in the cohort. ER -