Five-year follow-up of a one-year self-management program for patients with COPD

Borghild K Lomundal^1,2, Aslak Steinsbekk^1,2
1Department of Public Health and General Practice, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; ²St Olavs Hospital, Trondheim, Norway

Objective: Investigate long-term effects 4 years after the end of a 1-year self-management program (SMP) with 30 hours of education and 16 hours of physical activity in patients with chronic obstructive pulmonary disease (COPD).
Methods: Prospective observational outcome study. SMP focused on improving disease related self-care skills. Main outcome measures were health-related quality of life, HRQoL, (St Georges Respiratory Questionnaire, SGRQ total) and exercise capacity (6-minute walk test, 6MWT).
Results: Thirty patients participated, 47% women. Baseline mean age was 67 years and mean pre-bronchodilator FEV₁ (forced expiratory volume in 1 second) percentage predicted was 41.3. HRQoL showed a statistical significant improvement during the 1-year intervention. Four years after the end of the program SGRQ total was similar to baseline value, 1.4 points (95% CI: –3.6 to 6.3, P = 0.580). Also 6MWT was similar to baseline value at the same test point, –10 m (95% CI: –27 to 8, P = 0.262), and 63% reported having continued to exercise regularly a minimum of three times per week during the follow-up period.
Conclusion: The participants in a 1-year self-management program with additional training had maintained their pre-intervention level of HRQoL and exercise capacity 4 years after the end of the program. Two out of three participants had continued to exercise regularly.

Keywords: chronic obstructive pulmonary disease, outpatient, patient education, self-care ability, self-management