title: Action plans for COPD: strategies to manage exacerbations and improve outcomes.
abstract: COPD is the third-largest killer in the world, and certainly takes a toll on the health care system. Recurrent COPD exacerbations accelerate lung-function decline, worsen mortality, and consume over US$50 billion in health care spending annually. This has led to a tide of payment reforms eliciting interest in strategies reducing preventable COPD exacerbations. In this review, we analyze and discuss the evidence for COPD action plan-based self-management strategies. Although action plans may provide stabilization of acute symptomatology, there are several limitations. These include patient-centered attributes, such as comprehension and adherence, and nonadherence of health care providers to established guidelines. While no single intervention can be expected independently to translate into improved outcomes, structured together within a comprehensive integrated disease-management program, they may provide a robust paradigm.
authors.affiliation: Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, USA.
authors.forename: Leena
authors.initials: L
authors.lastname: Jalota
authors.affiliation: Department of Internal Medicine, Division of Pulmonary and Critical Care Medicine, University of California, San Francisco, USA; Chronic Lung Disease Program, UCSF-Fresno, Community Regional Medical Center, Fresno, CA, USA.
authors.forename: Vipul V
authors.initials: VV
authors.lastname: Jain
mesh_terms: D015897:Comorbidity; D032882:Comprehension; D019033:Delivery of Health Care, Integrated / Q000379:methods*; D019468:Disease Management; D018450:Disease Progression; D007722:Health Knowledge, Attitudes, Practice; D006304:Health Status; D006801:Humans; D008168:Lung / Q000503:physiopathology*; D008603:Mental Health; D010349:Patient Compliance; D010353:Patient Education as Topic; D010641:Phenotype; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000628:therapy*; D012307:Risk Factors; D012648:Self Care / Q000379:methods*; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: exacerbations; integrated disease-management program; self-management