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Supported self-management in COPD

Module summary

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

Learning objectives

After completing the module, you should:

  • be able to give examples of personal characteristics of a patient that may influence their ability to self-manage their condition
  • appreciate the benefits and challenges of COPD action plans
  • be aware of key considerations when delivering self-management advice
  • be familiar with the role of smoking cessation in COPD self-management
  • understand the role of pulmonary rehabilitation in improving COPD outcomes and the requirements when implementing such programmes.

Author details

This 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 the symptoms and treatment requirements of their condition with the support of healthcare professionals. The patient will often need to make physical, emotional and social adjustments to maintain their functioning and reduce the impact of the condition on their daily lives.1,2 Family, friends and carers will play a significant role too.

A key factor in COPD self-management is the early recognition and treatment of exacerbations by the patient, since such episodes can occur unpredictably and place an immense burden on both the patient (their quality of life) and the healthcare system and can accelerate decline in their overall condition.3,4 Other challenges a patient may have to contend with when self-managing their COPD include tobacco dependence, increasing disability, complex medication regimes, comorbidity and social isolation.5 Self-management education in COPD therefore must include both acute and chronic components – patients need advice and support on how to maintain their overall level of health and how to deal with exacerbations.

The impact of self-management on COPD outcomes has been studied. A Cochrane Review found that self-management education reduced hospital admissions, and significantly improved breathlessness and respiratory-related quality of life in patients.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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The Primary Care Respiratory Academy has been developed and is produced by Cogora, the publisher of Pulse, Nursing in Practice and Healthcare Leader working in partnership with PCRS-UK. All educational content for the website and roadshows has been initiated and produced by PCRS-UK/Cogora.

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