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Primary Care Integrated Management of chronic obstructive pulmonary disease (PRIM-COPD): study protocol for a
Yiwen Yu1, Xiaoxia Ren2, Xu Chu2
1School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
BMJ Open Respiratory Research
|July 8, 2026
Summary
This study evaluates a new COPD management program in China to improve patient care and reduce exacerbations. The findings will help optimize national COPD treatment standards.
Area of Science:
- Pulmonary Medicine
- Public Health
- Health Services Research
Background:
- Chronic Obstructive Pulmonary Disease (COPD) presents a significant global health challenge, particularly in China.
- Current COPD management faces limitations in early diagnosis, treatment adherence, and long-term care, especially within primary healthcare settings.
Purpose of the Study:
- To assess the effectiveness and feasibility of the National Essential Public Health Services (NEPHS) approach for COPD management.
- To provide evidence for enhancing national COPD care standards in China.
Main Methods:
- A multicentre, cluster-randomised controlled trial (the PRIM trial) involving primary healthcare institutions in China.
- Participants are adults (≥35 years) with spirometry-confirmed COPD, randomised to the PRIM intervention or usual care.
- The PRIM intervention includes regular GP-led follow-ups, health education, and disease management guided by pilot NEPHS COPD guidelines.
Main Results:
- Co-primary outcomes include the annual rate of acute exacerbations and health-related quality of life (using EQ-5D-5L).
- Secondary outcomes assess smoking status, COPD Assessment Test (CAT) scores, dyspnoea, and GP knowledge.
- Intention-to-treat analyses will be performed using multivariable regression, accounting for clustering.
Conclusions:
- The PRIM trial aims to generate crucial evidence for optimising COPD management strategies within China's primary care system.
- Findings will inform the refinement of national guidelines and improve long-term outcomes for COPD patients.
Keywords:
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