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Self‐management plans in the primary care of patients with chronic obstructive pulmonary disease
Author(s) -
McGEOCH Graham R. B.,
WILLSMAN Karen J.,
DOWSON Claire A.,
TOWN George I.,
FRAMPTON Christopher M.,
McCARTIN Fiona J.,
COOK Julie M.,
EPTON Michael J.
Publication year - 2006
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/j.1440-1843.2006.00892.x
Subject(s) - medicine , copd , self management , quality of life (healthcare) , attendance , physical therapy , hospital anxiety and depression scale , randomized controlled trial , anxiety , disease management , patient education , depression (economics) , family medicine , disease , nursing , psychiatry , machine learning , computer science , parkinson's disease , economics , macroeconomics , economic growth
Objective and background: The role of COPD self‐management plans in improving health outcomes remains unclear. The objective of this study was to assess whether self‐management plans administered in primary care have beneficial effects on quality of life, self‐care behaviour and health outcomes in the long term for patients with COPD. Material, patients and methods: The study was a prospective, unblinded, randomized controlled trial of usual care vs. usual care plus structured education on the use of a written self‐management plan and patient‐initiated short courses of antibiotics and oral corticosteroids. The study was conducted in general practice, in Christchurch, New Zealand. Participants were 159 patients with COPD randomized by general practice site into control or intervention groups. The primary outcome measure was change in St. George’s Respiratory Questionnaire. Secondary variables were frequency of hospital and primary‐care attendance, frequency of use of courses of antibiotics and oral corticosteroids over 12 months, and change in Hospital Anxiety and Depression Scale. Self‐management knowledge was assessed using a structured interview, the COPD Self‐Management Interview. Results: Self‐management plans and structured education were associated with higher levels of self‐management knowledge at 12 months, but had no effect on change in St. George’s Respiratory Questionnaire, health utilization, mental health or self‐reported outcomes of patients with COPD managed in general practice. Conclusions: Self‐management knowledge was higher in the intervention group but there was no difference in quality of life or health outcomes due to self‐management plans.