The aim of an exploratory study conducted by Lemmens and coworkers was to investigate to what extent primary care professionals are able to change their systems for delivering care to chronic obstructive pulmonary disease (COPD) patients. The investigators also sought to determine what professional and organizational factors are associated with the degree of process implementation. The research featured a quasi-experimental design with one-year follow-up after intervention conducted at three regional COPD management program in the Netherlands, in which general practices cooperated with regional hospitals. A total of 52 primary care professionals participated in the COPD management program. The main outcome measures were professional commitment, organizational context, and degree of process implementation. Professionals significantly changed their systems for delivering care to COPD patients, namely self-management support, decision support, delivery system design, and clinical information systems. Associations were found between organizational factors, professional commitment, and changes in processes of care. Group culture and professional commitment appeared to be, to a moderate degree, predictors of process implementation.

WHAT THE STUDY MAY MEAN TO YOU AS A HEALTH CARE PROVIDER: The authors concluded that COPD management was effective; all processes improved significantly. Moreover, theoretically expected associations between organizational context and professional factors with the implementation of COPD management were confirmed to some extent. Group culture and professional commitment appear to be important facilitators.

WHAT THE STUDY MAY MEAN TO YOU AS A PATIENT: The study showed that health care professionals could provide better care to COPD patients. This mainly revolved around changing practices to involve patients more in their own treatment. There is little doubt that self-management programs can benefit patients with COPD; the current study indicated that professionals could alter their practices to provide such treatment. If you have been diagnosed with COPD, insist that your health care provider refer you to a self-management program. They are often available within health facilities or through organizations such as the American Lung Association or the American Cancer Society.

K Lemmens et al. Professional commitment to changing chronic illness care: results from disease management programmes. International Journal for Quality in Health Care, April 22, 2009.