{"doi":"10.1101/2020.05.19.20107110","title":"Impact of Proactive Integrated Care on Chronic Obstructive Pulmonary Disease","abstract":"Background. Up to 50% of COPD patients do not receive recommended care for COPD. To address this important issue, we developed Proactive Integrated Care (Proactive iCare), a healthcare delivery model that couples integrated care with remote monitoring. Methods. We conducted a prospective, quasi-randomized clinical trial in 511 patients with advanced COPD, or a recent COPD exacerbation, to test whether Proactive iCare impacts patient- centered outcomes and healthcare utilization. Patients were allocated to Proactive iCare (n =352) or Usual Care (n = 159), and were examined for changes in quality of life using the St. Georges Respiratory Questionnaire (SGRQ), symptoms, guideline-based care, and healthcare utilization. Findings. Proactive iCare improved the total SGRQ by 7-9 units (p<0.0001), symptom SGRQ by 9 units (p<0.0001), activity SGRQ by 6-7 units (p<0.001) and impact SGRQ by 7-11 units (p<0.0001) at 3, 6 and 9 months, compared with Usual Care. Proactive iCare increased the 6-minute walk distance by 40 m (p<0.001), reduced COPD-related urgent office visits by 76 visits per 100 subjects (p<0.0001), identified unreported exacerbations, and decreased smoking (p = 0.01). Proactive iCare also improved cough, sputum, shortness of breath, the BODE index and oxygen titration (p<0.05). Mortality in the Proactive iCare group (1.1%) was not significantly different than mortality in the Usual Care group (3.8%; p = 0.08). Interpretation. Results suggest that linking integrated care with remote monitoring improves the lives of people with advanced COPD.","journal":"medRxiv","year":2020,"id":129734,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9553,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":362564,"name":"Sung‐Joon Min","orcid":null,"position":1,"is_corresponding":false},{"id":362566,"name":"Debora L. P. Diaz","orcid":null,"position":2,"is_corresponding":false},{"id":362565,"name":"Tammie J. Freitag","orcid":null,"position":3,"is_corresponding":false},{"id":362567,"name":"Shannon S. James","orcid":null,"position":4,"is_corresponding":false},{"id":362568,"name":"Norbert F. Voelkel","orcid":null,"position":5,"is_corresponding":false},{"id":362569,"name":"Derek J. Linderman","orcid":null,"position":6,"is_corresponding":false},{"id":362570,"name":"Fernando Diaz del Valle","orcid":null,"position":7,"is_corresponding":false},{"id":360749,"name":"Richard Albert","orcid":"0000-0001-5212-5292","position":8,"is_corresponding":false},{"id":360750,"name":"Todd Bull","orcid":"0009-0003-6221-7790","position":9,"is_corresponding":false},{"id":251006,"name":"Arne Beck","orcid":"0000-0002-5304-9794","position":10,"is_corresponding":false},{"id":362572,"name":"Thomas J. Stelzner","orcid":null,"position":11,"is_corresponding":false},{"id":360751,"name":"Debra P. Ritzwoller","orcid":"0000-0001-7116-8458","position":12,"is_corresponding":false},{"id":362573,"name":"Christine Kveton","orcid":null,"position":13,"is_corresponding":false},{"id":362574,"name":"Stephanie Carwin","orcid":null,"position":14,"is_corresponding":false},{"id":360752,"name":"Moumita Ghosh","orcid":"0009-0000-8442-8044","position":15,"is_corresponding":false},{"id":32252,"name":"Robert L. Keith","orcid":"0000-0002-3275-2608","position":16,"is_corresponding":false},{"id":360753,"name":"John M. Westfall","orcid":"0000-0002-1070-0268","position":17,"is_corresponding":false},{"id":362575,"name":"R. William Vandivier","orcid":null,"position":18,"is_corresponding":false},{"id":362563,"name":"Patricia B. Koff","orcid":null,"position":0,"is_corresponding":true}],"reference_count":45,"raw_metadata":null,"created_at":"2026-07-18T23:15:49.682497Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}