Self-management behaviors to reduce exacerbation impact in COPD patients: a Delphi study
Received 5 April 2017
Accepted for publication 13 July 2017
Published 15 September 2017 Volume 2017:12 Pages 2735—2746
Checked for plagiarism Yes
Review by Single-blind
Peer reviewers approved by Dr Charles Downs
Peer reviewer comments 4
Editor who approved publication: Dr Richard Russell
Yvonne JG Korpershoek,1,2,* Joyce C Bruins Slot,1,* Tanja W Effing,3,4 Marieke J Schuurmans,1,2 Jaap CA Trappenburg1
1Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, 2Research Group Chronic Illnesses, University of Applied Sciences Utrecht, Utrecht, the Netherlands; 3Department of Respiratory Medicine, Southern Adelaide Local Health Network, 4School of Medicine, Flinders University, Adelaide, SA, Australia
*These authors contributed equally to this work
Background: Little is known about which self-management behaviors have the highest potential to influence exacerbation impact in COPD patients. We aimed to reach expert consensus on the most relevant set of self-management behaviors that can be targeted and influenced to maximize reduction of exacerbation impact.
Materials and methods: A 2-round Delphi study was performed using online surveys to rate the relevance and feasibility of predetermined self-management behaviors identified by literature and expert opinion. Descriptive statistics and qualitative analyses were used.
Results: An international expert panel reached consensus on 17 self-management behaviors focusing on: stable phase (n=5): pharmacotherapy, vaccination, physical activity, avoiding stimuli and smoking cessation; periods of symptom deterioration (n=1): early detection; during an exacerbation (n=5): early detection, health care contact, self-treatment, managing stress/anxiety and physical activity; during recovery (n=4): completing treatment, managing stress/anxiety, physical activity and exercise training; and after recovery (n=2): awareness for recurrent exacerbations and restart of pulmonary rehabilitation.
Conclusion: This study has provided insight into expert opinion on the most relevant and feasible self-management behaviors that can be targeted and influenced before, during and after an exacerbation to exert the highest magnitude of influence on the impact of exacerbations. Future research should focus at developing more comprehensive patient-tailored interventions supporting patients in these exacerbation-related self-management behaviors.
Keywords: COPD, self-management, exacerbation, Delphi study, self-care, Delphi technique and behavior
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