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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 six 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 the intervention group subjects. After six 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 seterioting symptoms, 34 versus7% (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 shpw any difference in quality of life or lung function parameters. A larger prospective controlled clinical trial of this approach is warranted |
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