Effects of self-management action plans for COPD patients with comorbidities on health status and self-efficacy

This self-management (SM) trial evaluated tailored action plans for exacerbations of COPD and comorbid conditions in Australian and Dutch patients. Primary outcome analyses demonstrated a reduction in COPD exacerbation duration and respiratory-related hospitalisation rate. This abstract reports secondary study endpoints.COPD patients (≥ 40 years, GOLD II-IV) with ≥ 1 comorbidity (ischemic heart disease, chronic heart failure, diabetes mellitus, anxiety, depression) were randomised to a SM intervention including individualised exacerbation action plans for COPD and comorbidities (n=102) or usual care (n=99). Health status (Chronic Respiratory Disease (CRQ) and the Hospital Anxiety and Depression Scale (HADS)), self-efficacy (COPD Self-Efficacy Scale (CSES)), and fatigue were assessed at baseline, 6 and 12 months. Between-group differences were studied with repeated measurements analyses.Compared to usual care, SM showed a significantly reduced behavioural risk factors CSES domain (difference -0.26 (95% CI -0.52;-0.01), p=0.04) and a significantly worse emotional function CRQ domain (difference -0.41 (95% CI -0.70;-0.11), p<0.01). No between-group differences were observed in fatigue, HADS, or other CRQ or CSES domains after 12 months follow-up.SM including exacerbation action plans for COPD and comorbidities improved patients’ self-efficacy to prevent breathing difficulty. Lower emotional function scores in the SM group were not accompanied with HADS changes and...

Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Lenferink, A., van der Palen, J., van der Valk, P., Cafarella, P., van Veen, A., Quinn, S., Groothuis-Oudshoorn, C., Burt, M., Young, M., Frith, P., Effing, T. Tags: Rehabilitation and Chronic Care Source Type: research