PURPOSE:The aim of this study was to determine the effect of training in self-management on patients admitted with COPD exacerbation.
METHODS:This is a single center, prospective study carried out involving 92 patients admitted for COPD exacerbation. Equal number of study participants were assigned to the usual care group and the intervention group who received a modified version of disease-specific self-management program, “Living Well with COPD”.
RESULTS:Most patients in the study were elderly, Afro-American, and with low educational attainment. Half of the patients have either MEDICARE or MEDICAID, and two thirds of the patients have previous hospital admission within a year for COPD exacerbation. Three months after hospital discharge, the COPD patients who received self-management training have better compliance with outpatient follow-up than the usual care group. COPD patients in the self-management group also had significantly better SGRQ score as compared to the control group. Determinants of outpatient compliance included having higher educational attainment, having a previous hospitalization, and being a patient in the pulmonary clinic. Moreover, patients with lower lung function and poorer SGRQ score were also more likely to comply with out-patient follow-up.
CONCLUSION:In conclusion, this study demonstrated the positive effect of self-management skills among patients admitted with COPD exacerbation on compliance with outpatient follow-up. The study also showed that self-management programs can improve the quality of life of patients with severe COPD three months after hospital discharge.
CLINICAL IMPLICATIONS:The present study supports the use of self-management program as an integral part of the long-term care of patients with advanced COPD.
DISCLOSURE:Roberto Santos, No Financial Disclosure Information; No Product/Research Disclosure Information