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The intervention practices undertook an active, structured implementation of a disease management programme for COPD.
The multifaceted implementation of a disease management programme for COPD made general practice follow the programme and proactively perform follow-up consultations and spirometries.
The implementation of a disease specific score such as the CURB-65 clinical prediction rule has helped predict mortality risk and guide treatment options in patients with community acquired pneumonia.
Common elements of these plans include the drafting of a national framework for the provision of chronic care, the promotion of integrated care, the implementation of a disease management processes and the set-up of personal health care plans [ 12].
One cohort study found that implementation of a disease management programme reduced readmissions to hospital [ 25], but only few studies have examined the effectiveness of disease management programmes targeting patients with COPD [ 26, 27].
Our finding of less use of hospital services after active implementation of a disease management programme is highly relevant as other studies have shown an increase of 2.3 in hospital admission rates for COPD patients compared with patients without COPD [ 58].
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A particular effort has been undertaken over the last years to fight preventable diseases and improve routine immunization coverage through the implementation of a diseases control plan and the "Reach Every District" approach.
We believe that the implementation of such a disease control program utilizing existing information on the genetics of circulating rabies viruses in a country like Thailand could be successful if the campaign target areas have been carefully selected and limited to one circulating phylogroup of virus and the movement of dogs along human transportation routes into the area is strictly enforced.
The purpose of the present study was to examine the experiences of COPD patients and their relatives of integrated care after implementation of a COPD disease management programme.
Meanwhile, the implementation of a proactive disease prevention protocol linked to Dutch primary care may create opportunities to initiate conversations about FH more systematically [ 16, 24].
Consequently, the aim of the present study was to examine how COPD patients and their relatives experience integrated care across care settings after the implementation of a COPD disease management programme.
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