Does patient education modify behaviour in the management of COPD?

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Abstract

With respect to the beneficial health effects of patient education in the treatment of asthma it might be expected that the active participation of COPD-patients in the management of their disease may reduce the burden of the disease. Self-management of chronic obstructive pulmonary disease (COPD) includes sufficient coping behaviour, compliance with inhaled medication, attention to changes in the severity of the disease, adequate inhalation technique, and self-adjustment of the medication in case of exacerbations. In contrast to the conflicting results of the current literature, the evaluation of our structured education programme for patients with mild to moderate COPD revealed a significant improvement of inhalation technique and self-control of the disease as well as a significant reduction of exacerbations. Therefore, it may be concluded that education may modify the behaviour of patients in the management of COPD by improving self-control and self-management of the disease and thus reducing morbidity.

Section snippets

Self-management in patients with COPD

In asthma, many studies have shown that self-management is the most important item of successful patient education programs [1]. Evaluation of patient education programs for patients with asthma, including self-management, revealed a better quality of life, reduced morbidity and a marked reduction in health costs [1].

With respect to the positive effect of self-management in the treatment of asthma it might be expected that changes of behaviour be educating self-management skills for patients

Teaching items

The education program should enable patients with COPD to analyse the degree of their airflow limitation continuously at home, to check the efficiency of their medical treatment, and to change their drug regimen with respect to the actual degree of airflow limitation on their own.

Furthermore, clear-cut guidelines for the requirement of immediate emergency medical care should be given [2]. An effective teaching and treatment program for patients with COPD should include information about the

Impact of patient education

As for other components of the treatment of COPD, the efficiency of education programs including self-management should be evaluated. Up to now, little is known about the effectiveness of self-management and behaviour modification, in contrast to the situation in asthma. The conflicting results of a few small sized studies highlight an area for further clinical evaluation [3].

Discussion

The better outcome of patient education in asthma with respect to COPD may be due to the fact that self-management plans may suit the patient with variable symptoms due to asthma better than patients with COPD. The asthmatics may be motivated to stick to the self-management plan by experiencing that it works. Changes in PEF values and symptoms lead to changes in medication according to an action plan and a subsequent improvement in these measures. If the patients with COPD observe limited

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