Feasibility and effectiveness of an educational program in Italian COPD patients undergoing rehabilitation.
BACKGROUND
Self-management education is associated with improvement in quality of life and reduction of hospital admissions. Nevertheless, the data are insufficient to formulate clear recommendations regarding the type and content of education programs for COPD patients, and few data are available on knowledge of the disease itself.


OBJECTIVE
To test the level of patients' knowledge of their disease and therapy at baseline and after an educational program (COPD-EP); the feasibility of structured educational sessions; the influence of clinical status (degree of severity of disease, presence of comorbidities, oxygen use), demographics status (age, sex), previous knowledge level, previous lessons attendance and adherence of COPD-EP to the variation of knowledge after program.


METHODS
Selected COPD in-patients and out-patients referred to rehabilitative hospital departments were enrolled. The study was divided into 2 parts: a pre-study phase (educational materials and health team preparation) and a study phase. All COPD subjects received one educational brochure and were invited to attend seven 30-min group lessons to complete the educational program. Learning effect was evaluated by a 20-questions multiple choice learning questionnaire (LQ).


RESULTS
We enrolled 158 subjects, of whom 44.9% had previous formal education lessons on COPD management and 69.6% had previous rehabilitative hospitalizations. At baseline, the LQ total score was 15.2 ± 3.5 points, which increased to 16.9 ± 3.0 points post COPD-EP (P < .001). Pre-to-post change of LQ scores significantly correlated with adherence (R = 0.24, P = .002) and Severity Index of Cumulative Illness Rating Scale score (R = -0.22, P = .001). Subjects with low baseline knowledge were more likely to have improved LQ scores than subjects with greater levels of knowledge. Subjects without prior educational COPD lessons improved more than subjects who had attended previous education.


CONCLUSIONS
A formal COPD-EP is feasible and effective in improving subject knowledge and self-management. Specific learning instruments to follow up this population should be validated.
Respiratory Division, Fondazione Salvatore Maugeri, Istituto di Ricovero e Cura a Carattere Scientifico, Lumezzane, Italy. mara.paneroni@fsm.it
Mara
M
Paneroni
Enrico
E
Clini
Ernesto
E
Crisafulli
Enrico
E
Guffanti
Alessia
A
Fumagalli
Antonella
A
Bernasconi
Antonella
A
Cabiaglia
Antonello
A
Nicolini
Stefania
S
Brogi
Nicolino
N
Ambrosino
Roberta
R
Peroni
Luca
L
Bianchi
Michele
M
Vitacca
D000368:Aged; D005240:Feasibility Studies; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010353:Patient Education as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D011788:Quality of Life; D012648:Self Care; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires