The influence of adherence to COPD exacerbation action plans on health outcomes

Abstract

<b>Aim:</b> We explored associations between various adherence categories to COPD exacerbation action plans, and health outcomes. <b>Methods:</b> Data came from self-treatment intervention groups of two COPD self-management trials, including patients that experienced ≥1 COPD exacerbation during one year follow up. Optimal treatment was defined as ‘self-initiating treatment &lt;2 days from the COPD exacerbation start’. Regression models were built for the health outcomes COPD exacerbations, hospitalisations, health-related quality of life, anxiety, and depression. <b>Results:</b> Of the 101 patients (COPD exacerbations: mean 3.0 (SD 2.5)), 38 treated their exacerbation optimal, 17 sub-optimal, and 46 with significant delay or not at all. We observed a significantly lower number of COPD exacerbation days/patient/year for ‘optimal treatment’ (-32.8 (95% CI -54.9;-10.8) days) and ‘sub-optimal treatment’ (-33.8 (95% CI -62.1;-5.5) days), compared to ‘significant delay or no treatment’. Duration of COPD exacerbations was significantly shorter for ‘optimal treatment’ (-7.4 days) and ‘sub-optimal treatment’ (-6.7 days), compared to ‘significant delay or no treatment’. No associations were found between adherence categories and other health outcomes. <b>Conclusion:</b> Our results show that patients with ‘optimal or sub-optimal treatment9 adherence to exacerbation action plans had significantly fewer COPD exacerbation days/patient/year and a shorter COPD exacerbation duration, compared with those showing ‘significant delay or no treatment’. These findings highlight the importance of patients9 adherence in timely using&nbsp;COPD exacerbation action plans. Therefore, interventions should include strategies that aim to optimise adherence.