An integrated health-sector strategy to combat COPD and asthma in Vietnam: A pragmatic stepped intervention cluster randomized trial

Background

Chronic lung disease is a mounting health priority for Vietnam, with over 10% of the population suffering from either COPD or asthma and three out of every four adult males having a history of smoking Evidence-based interventions to prevent and reduce the burden of chronic obstructive lung disease (OLD) are well-established internationally, however such strategies currently reach only a small proportion of the most vulnerable populations in this resource-limited setting. Furthermore, a lack of local evidence has deterred policy-makers from applying these approaches.

Aims

1. To determine the effect of a smoking cessation intervention upon the rate of sustained abstinence among smokers after two years;

2. To evaluate the effectiveness of an integrated SC and ICS intervention upon the proportion of individuals with one or more exacerbations of COPD or asthma within two years of follow-up;

Secondary objectives

• To determine the effect of the combined intervention upon all-cause mortality

• To determine physician and patient compliance with a structured clinical decision algorithm for patients with persistent and/or recurrent respiratory symptoms.

• To conduct a cost-effectiveness analysis of smoking cessation among smokers, and the combined intervention among patients with OLD.

• To evaluate the knowledge, attitudes and beliefs of patients and health care workers regarding smoking cessation and ICS use before and after the intervention.

• To disseminate findings: engaging local and national policy-makers in translating the established protocols into practice and policy.

Impact

The project showed that implementing a quitline to help people stop smoking, combined with brief counselling was feasible in the local (district level) healthcare system in Vietnam. The team are continuing efforts to influence national guidelines and scale up the study.

Publications and output

To access publications and other outputs relating to this project, see our publications webpage.

You can also visit the VCAPS project webpage for more information.

Funding organisations

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