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Pilot Study in the Use of Human Patient Simulator (HPS) as a Novel Approach to COPD Self-Management FREE TO VIEW

Juan Rojas-Gomez; Perry Nystrom; Robert Gauder; Debi Sampsel; Steve Wetzel; Kim Bloch; Shelly Duckworth; Tonia Taylor
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Wright State University, Dayton, OH

Chest. 2014;146(4_MeetingAbstracts):23A. doi:10.1378/chest.1988325
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SESSION TITLE: COPD Diagnosis and Evaluation Posters I

SESSION TYPE: Original Investigation Poster

PRESENTED ON: Wednesday, October 29, 2014 at 01:30 PM - 02:30 PM

PURPOSE: To provide a skill-transfer teaching technique to patients with severe COPD.

METHODS: Written consent was obtained from 23 Veterans Affairs patients. All subjects had severe COPD (FEV1<50% predicted, mean FEV1/FVC 49%). Subjects were randomized to routine care or a three-hour, multidisciplinary class including pulmonary medicine, pulmonary rehabilitation, respiratory therapy, nursing care, and physiotherapy. The session incorporated HPS in different clinical scenarios with interactive teaching sessions about COPD pathophysiology, medications, breathing techniques, dyspnea crisis, and aerobic exercise/strength training. Participants completed pre- and post-education session questionnaires on their experiences.

RESULTS: Eight subjects attended the education class with HPS. All participants rated the class as good to excellent; 6/8 reported increased understanding about COPD; 7/8 reported improved knowledge about proper inhaler use technique; 5/8 reported wanting to increase exercise/activity as part of their self-management; 3/8 reported wanting to change the way they use their inhalers; 6/8 reported wanting to attend another HPS class; and 7/8 would recommend HPS classes to others.

CONCLUSIONS: Use of HPS was well received by the participants. We propose the use of HPS as a didactical tool for group settings to improve patient understanding about COPD with the goal of providing the skills necessary for optimal COPD self-management. Ultimately, better knowledge about COPD and its treatment can help this high risk COPD cohort better manage dyspnea crisis and avoid subsequent hospitalizations.

CLINICAL IMPLICATIONS: Current studies show conflicting results about the benefits of COPD self-management and the use of concomitant COPD education and pulmonary rehabilitation. So far, self-management has focused on the recognition and treatment of COPD exacerbations. We present a novel approach focusing on a skill-transfer technique to improve understanding of the disease, medication use, medication adherence, and development of coping skills that can help avoid unnecessary hospitalizations due to episodic breathlessness. Larger studies are needed to validate these conclusions and assess whether HPS is a viable educational tool that can lead to better outcomes in COPD self-management and reduce hospitalizations due to dyspnea crisis.

DISCLOSURE: The following authors have nothing to disclose: Juan Rojas-Gomez, Perry Nystrom, Robert Gauder, Debi Sampsel, Steve Wetzel, Kim Bloch, Shelly Duckworth, Tonia Taylor

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