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Supported self-management in COPD

Posted on: 28 Jun 2017
 

Module summary

This module will evaluate key aspects in the self-management of COPD by patients.

Learning objectives

  • List patient characteristics that may influence their ability to self-manage their condition
  • Appreciate the benefits and challenges of COPD action plans
  • Recognise key considerations when delivering self-management advice
  • Know the role of smoking cessation in COPD self-management
  • Understand the role of pulmonary rehabilitation in improving COPD outcomes, and the requirements to implement such programmes.

Author details

The content for this module was originally created by Steph Wolfe, PCRS-UK Nurse Consultant.

Introduction

Self-management of a chronic condition involves the patient themselves addressing their symptoms and treatment requirements, supported by healthcare professionals.

Patients will often need to make physical, emotional and social adjustments in order to reduce the impact of the condition on their daily lives.1,2 Family, friends and carers also will play a significant role.

Self-management plans must be individualised to make them appropriate for a particular patient. Guidance on how to do that can be found in this article on “Tailoring a plan for supported self-management to the patient”. Additional guidance and a template plan have also been produced by the London Respiratory Network.

In COPD self-management, early recognition and treatment of exacerbations is particularly important. These episodes can occur unpredictably. They place an immense burden on not only the patient but also the healthcare system, and can accelerate a patient’s overall decline.3,4

Other challenges faced by a patient with COPD may include:

  • tobacco dependence
  • increasing disability
  • complex medication regimes
  • comorbidity
  • social isolation.5
  • COPD self-management education therefore must include both acute and chronic components. Patients need advice on both how to maintain their overall level of health and how to deal with exacerbations.

    Self-management education in COPD reduces hospital admissions, and significantly improves breathlessness and respiratory-related quality of life.6

    The current Primary Care Respiratory Society UK (PCRS-UK) guide places ‘an emphasis on encouragement of guided self-management’ in COPD.7,8 National Institute for Health and Care Excellence (NICE) and Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines also highlight the importance of self-management in COPD.8,9

    List of abbreviations
    ABGs Arterial blood gases HbA1c Haemoglobin A1c
    BMI Body mass index ICS Inhaled corticosteroid
    BTS British Thoracic Society LABA Long-acting beta agonist
    COPD Chronic obstructive pulmonary disease LAMA Long-acting muscarinic antagonist
    CPD Continuing professional development MRC Medical Research Council
    ECG Electrocardiogram NICE National Institute for Health and Care Excellence
    FBC Full blood count NRT Nicotine replacement therapy
    FEV1 Forced expiratory volume in 1st second PCRS-UK Primary Care Respiratory Society UK
    GOLD Global Initiative for Chronic Obstructive Lung Disease SABA Short-acting beta agonist
    GP General practitioner

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