Optimizing nonpharmacological management following an acute exacerbation of chronic obstructive pulmonary disease.
Though the guidelines for the optimal management of chronic obstructive pulmonary disease (COPD) following an acute exacerbation (AE) are well established, issues associated with poor adherence to nonpharmacological interventions such as self-management advice and pulmonary rehabilitation will impact on hospital readmission rates and health care costs. Systems developed for clinically stable patients with COPD may not be sufficient for those who are post-exacerbation. A redesign of the manner in which such interventions are delivered to patients following an AECOPD is necessary. Addressing two or more components of the chronic care model is effective in reducing health care utilization in patients with COPD, with self-management support contributing a key role. By refining self-management support to incorporate the identification and treatment of psychological symptoms and by providing health care professionals adequate time and training to deliver respiratory-specific advice and self-management strategies, adherence to nonpharmacological therapies following an AE may be enhanced. Furthermore, following up patients in their own homes allows for the tailoring of advice and for the delivery of consistent health care messages which may enable knowledge to be retained. By refining the delivery of nonpharmacological therapies following an AECOPD according to components of the chronic care model, adherence may be improved, resulting in better disease management and possibly reducing health care utilization.
Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada.
Samantha L
SL
Harrison
Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada.
Roger
R
Goldstein
Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada.
Laura
L
Desveaux
Department of Respiratory Medicine, West Park Healthcare Centre, Toronto, ON, Canada.
Verity
V
Tulloch
Department of Medicine Physical Therapy, University of Toronto, Toronto, ON, Canada.
Dina
D
Brooks
D003131:Combined Modality Therapy; D018450:Disease Progression; D005081:Exercise Therapy; D015438:Health Behavior; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D010102:Oxygen Inhalation Therapy; D010353:Patient Education as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D012648:Self Care; D016896:Treatment Outcome
acute exacerbation; adherence; chronic care model; chronic obstructive pulmonary disease; oxygen; physical activity; pulmonary rehabilitation; self-management