title: Evaluation of a self-management plan for chronic obstructive pulmonary disease.
abstract: We hypothesized that the use of an Action Plan might assist self-management for patients with chronic obstructive pulmonary disease (COPD). A pilot process and randomized, controlled study were undertaken to evaluate an Action Plan that provided advice on management of usual care and exacerbations, together with a booklet on self-management. Fifty six subjects with COPD recruited through general practitioners (GPs) completed the 6 month study, 27 in the control group and 29 in the intervention group. The control group received usual care from their GP, and the intervention group received a booklet and Action Plan from their practice nurse plus a supply of prednisone and antibiotic from their GP. The two groups were demographically similar with a mean age of 68 yrs. The resources were well received by GPs, practice nurses and intervention group subjects. After 6 months, there were no differences in quality of life scores or pulmonary function. There were significant changes in self-management behaviour in the intervention group compared to controls. In response to deteriorating symptoms, 34 versus 7% (p=0.014) initiated prednisone treatment and 44 versus 7% (p=0.002) initiated antibiotics. Subjects in the intervention group readily adopted self-management skills but did not show any difference in quality of life or lung function parameters. A larger, prospective, controlled, clinical trial of this approach is warranted.
authors.affiliation: Canterbury Respiratory Services, Canterbury Health, Christchurch, New Zealand.
authors.forename: P B
authors.initials: PB
authors.lastname: Watson
authors.forename: G I
authors.initials: GI
authors.lastname: Town
authors.forename: N
authors.initials: N
authors.lastname: Holbrook
authors.forename: C
authors.initials: C
authors.lastname: Dwan
authors.forename: L J
authors.initials: LJ
authors.lastname: Toop
authors.forename: C J
authors.initials: CJ
authors.lastname: Drennan
mesh_terms: D000368:Aged; D005260:Female; D005541:Forced Expiratory Volume; D006801:Humans; D008173:Lung Diseases, Obstructive / Q000503:physiopathology / Q000628:therapy*; D008297:Male; D010174:Pamphlets; D010353:Patient Education as Topic; D017060:Patient Satisfaction; D012648:Self Care