Abstract
Self-management support for chronic obstructive pulmonary disease (COPD) patients is recommended by UK national guidelines, but extent of implementation is unknown. We aimed to describe self-management behaviour and support among COPD patients and explore behaviour associated with having a self-management plan. We undertook cross-sectional analysis of self-reported data from diagnosed COPD patients in the Birmingham COPD Cohort study. Questionnaire items relevant to self-management behaviour, knowledge of COPD, receipt of self-management plans and advice from healthcare professionals were examined. Multiple regression models were used to identify behaviour associated with having a self-management plan. One-thousand seventy-eight participants (676 males, 62.7%, mean age 69.8 (standard deviation 9.0) years) were included. The majority reported taking medications as instructed (940, 94.0%) and receiving annual influenza vaccinations (962, 89.2%). Only 400 (40.4%) participants had self-management plans, 538 (49.9%) reported never having received advice on diet/exercise and 110 (42.7%) current smokers had been offered practical help to stop smoking in the previous year. General knowledge about COPD was moderate (mean total Bristol COPD Knowledge Questionnaire score: 31.5 (standard deviation 10.7); max score 65), corresponding to 48.5% of questions answered correctly. Having a self-management plan was positively associated with self-reported adherence to medication (odds ratio 3.10, 95% confidence interval 1.43 to 6.72), attendance at a training course (odds ratio 2.72, 95% confidence interval 1.81 to 4.12), attendance at a support group (odds ratio 6.28, 95% confidence interval 2.96 to 13.35) and better disease knowledge (mean difference 4.87, 95% confidence interval 3.16 to 6.58). Primary care healthcare professionals should ensure more widespread implementation of individualised self-management plans for all patients and improve the lifestyle advice provided.
Highlights
Chronic obstructive pulmonary disease (COPD) is an important long-term condition characterised by persistent decline in airflow[1] and increasing breathlessness
Self-management support programmes should be collaborative between healthcare professionals and patients, to help them acquire skills to understand and manage their medications and exacerbations, adopt healthier behaviours and manage the social-emotional consequences of the disease.[7,8,9,10,11]
We describe the support that patients report receiving from their healthcare professionals and whether a collaborative self-management plan is associated with positive self-management behaviours in real life
Summary
Chronic obstructive pulmonary disease (COPD) is an important long-term condition characterised by persistent decline in airflow[1] and increasing breathlessness. Support to help COPD patients self-manage their condition is recommended by national guidelines to improve their healthrelated quality of life and reduce avoidable inpatient admissions.[5, 6] Exact definitions of self-management and the most effective components of interventions to support patients are ongoing debates.[7] Self-management support programmes should be collaborative between healthcare professionals and patients, to help them acquire skills to understand and manage their medications and exacerbations, adopt healthier behaviours and manage the social-emotional consequences of the disease.[7,8,9,10,11]
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