Abstract
BackgroundSelf-Management Support (SMS), refers to the actions taken by individuals to recognise and manage their own health. It is increasingly recognised that individuals with chronic obstructive pulmonary disease (COPD) require additional support with their Self-management. Emerging evidence suggests that the use of a social network intervention can improve health outcomes and increase quality of life. In order to understand the potential benefits of SMS in COPD, the GENIE (Generating Engagement in Network Support) SMS tool was implemented and evaluated in a COPD primary care context. The GENIE intervention is a social networking tool that consists of 3 parts; a concentric circle modelling to map existing social networks; a questions sections to elicit preferences for activities; a map of selected resources is then produced, aligned with the user’s interests and suggestions for connections to existing network members and to new resources.MethodsA pilot, parallel, single blind, block randomised controlled trial. Patients with COPD ranging from mild-very severe were recruited. Participants provided written consent and were then randomised to either the intervention or usual care. The primary aim was to understand the clinical benefit through the analysis of health status, symptom burden and quality of life. The secondary outcome measure was health utilisation. NHS cost differences were reported between groups using the GENIE intervention over usual care.ResultsThe GENIE pilot results demonstrate maintenance in health status and clinical symptoms with a decrease in anxiety. An overall increase in quality of life was observed, these findings did not reach significance. A cost reduction was demonstrated in inpatient stay with no difference in primary care costs. Overall a cost reduction in NHS service utilisation was indicated in the intervention group.ConclusionThis pilot study indicated that using a social network intervention can encourage the development of new social connections and extend existing support networks for COPD patients. Increasing network support in this population is of benefit to both patients and NHS providers in terms of cost reductions and enhancing wellbeing. This broadens the understanding of possible new approaches to SMS in community COPD patients, which could now be investigated in a larger population over a longer period.Trial registrationClinical Trials.gov PRS National Library of Medicine. Protocol ID number: 19175, Clinical Trial ID: NCT02935452.
Highlights
Self-Management Support (SMS), refers to the actions taken by individuals to recognise and manage their own health
The team was a mix of clinicians, physiotherapists, nurses and medical consultants delivering care to chronic obstructive pulmonary disease (COPD) patients in a deprived inner-city area falling within the 20–30% decile of deprivation [22], with a known higher than average prevalence of COPD [22]
Study flow and baseline characteristics Patients were recruited from an inner city region, containing the areas of highest deprivation [37] and COPD prevalence [22]
Summary
Self-Management Support (SMS), refers to the actions taken by individuals to recognise and manage their own health. It is increasingly recognised that individuals with chronic obstructive pulmonary disease (COPD) require additional support with their Self-management. Chronic obstructive pulmonary disease (COPD) is a progressive, life limiting condition, clinically characterised by airflow limitation, sputum hypersecretion and persistent breathlessness [1]. These enduring daily symptoms have a further impact on mobility, nutritional intake and mental health. As COPD prevalence and the related social burden grow, this in turn has a multifactorial impact of society, families, and health systems This is further augmented by deprivation [4], poor housing, continued tobacco use and poor literacy levels, often prevalent in COPD [5, 6] [7]. A longer-term solution is required to sustain the personal self-management activities, required by individuals to manage everyday life and to maintain wellbeing with concurrent COPD symptoms [11]
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