Global Excellence in COPD (GECO)

          Self-management of chronic respiratory illness has the potential to bring relief and improved quality of life to people who are not able to easily seek care at health facilities. The GECO cohort aims to first assess the diagnostic accuracy of a short COPD case-finding questionnaire before determining the clinical effectiveness, cost-effectiveness, and feasibility of implementation of a self-directed COPD Action Plan in three varying LMIC settings.
          The cohort will include an age- and sex-stratified random sample of approximately 12,000 adults age ≥40 years in Bhaktapur, Nepal; Lima, Peru; and Nakaseke, Uganda, each of which have been found to have a high prevalence of COPD. Each participant will have basic demographic information collected as well as anthropological measurements and spirometry testing. Those with COPD will be administered additional questionnaires, such as the LFQ, CAPTURE, MRC Dyspnea Scale, SGRQ, and EQ-5D. Based on current prevalence estimates, we anticipate recruiting 1,200 adults with COPD into the later stages of the study. Those who are enrolled will receive standardized COPD self-management education by trained Community Health Workers before being randomized into Action Plan or Standard Care groups. These groups will be followed up for one year with additional survey data collected.
          This cohort will be funded by the Medical Research Council of the United Kingdom as a collaboration between University College London (UK), Johns Hopkins University (USA), AB PRISMA (Peru), Cayetano Heredia University (Peru), York University (UK), Makerere University (Uganda), and the Institute of Medicine (Nepal).