Effectiveness of a partnership-based self-management programme for patients with mild and moderate chronic obstructive pulmonary disease: a pragmatic randomized controlled trial

• Published in: Journal of advanced nursing 2015-11, Vol.71 (11), p.2634-2649
• Main Authors: Jonsdottir, Helga, Amundadottir, Olof R., Gudmundsson, Gunnar, Halldorsdottir, Bryndis S., Hrafnkelsson, Birgir, Ingadottir, Thorbjorg Soley, Jonsdottir, Rosa, Jonsson, Jon Steinar, Sigurjonsdottir, Ellen D., Stefansdottir, Ingibjorg K.
• Format: Article
• Language: English
• Subjects: Aged; anxiety; Chronic obstructive pulmonary disease; Clinical trials; COPD; disease exacerbation; Disease management; Effectiveness; Experiments; Female; Humans; intervention studies; Male; Middle Aged; Nurse-Patient Relations; Nursing; Partnership Practice; Patient Satisfaction; Patients; Pulmonary Disease, Chronic Obstructive - nursing; Quality of Life; randomized controlled trial; Self Care - methods; self-care; smoking cessation; Treatment Outcome
• ISSN: 0309-2402; 1365-2648
• DOI: 10.1111/jan.12728

Aims To evaluate the effectiveness of a 6‐month, partnership‐based self‐management programme for patients with mild and moderate chronic obstructive pulmonary disease. Background Self‐management is a widely valued concept used to address contemporary issues of chronic health problems. Findings of self‐management programmes for people with chronic obstructive pulmonary disease are inconclusive. Design Pragmatic randomized control trial. Methods Patients, 45‐65 years old, with mild and moderate chronic obstructive pulmonary disease were invited with a family member. Experimental group (n = 48) participated in a 6‐month, partnership‐based self‐management programme consisting of: (a) three to four conversations between nurse and patient‐family member; (b) 6 months of smoking cessation; and (c) interdisciplinary team‐patient‐family member group meeting. Control group (n = 52) received usual care. Data were collected at months zero, six and 12. The trial lasted from June 2009–March 2013. Results Patients with mild and moderate chronic obstructive pulmonary disease who participated in the partnership‐based self‐management programme perceived less intrusiveness of the disease and its treatment than patients in the control group. Patients in the experimental group did not have better health‐related quality of life, less anxiety or depression, increased physical activity, fewer exacerbations or better smoking status than patients in the control group. Patients in both groups found participation in the research useful and important. Conclusion The partnership‐based self‐management programme had benefits concerning perception of the intrusiveness of chronic obstructive pulmonary disease and its treatment on lifestyles, activities and interests for young patients with the disease in its early stages. High satisfaction in control group, low family attendance and the relatively short treatment period may explain the less than expected benefits of the programme.