Evaluation of a self-management plan for chronic obstructive pulmonary disease

We hypothesized that the use of an Action Plan might assist selfmanagement 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 6 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 intervention group subjects. After 6 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 deteriorating symptoms, 34 versus 7% (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 show any difference in quality of life or lung function parameters, A Larger, prospective, controlled, clinical trial of this approach is warranted.