Self-management strategies in chronic obstructive pulmonary disease.
ABSTRACT This article enables the reader to understand the newest scientific concepts and advances in the field of self-management in chronic obstructive pulmonary disease, recognize the importance of self-management education and what might be needed to enhance behavior modification, and translate these advances into strategies and specific interventions in clinical practice.
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ABSTRACT: This study investigated if improvements can be maintained over 24 weeks when in-home pulmonary telerehabilitation is combined with asynchronous self-management education for Chronic Obstructive Pulmonary Disease (COPD). Twenty-three community-living elders with moderate to very severe COPD participated in a pre/post-intervention study. Over 8 weeks, they had access to self-learning capsules on self-management, received 15 in-home teletreatment sessions and were encouraged to gradually engage in unsupervised sessions. Participants were assessed before the intervention (T1), immediately after the intervention (T2), and 6 months later (T3). Outcome measures were (1) exercise tolerance (6-minute walk test [6MWT]), Cycle Endurance Test [CET]), and (2) quality of life (Chronic Respiratory Questionnaire [CRQ]). Although there were significant improvements after 8 weeks of pulmonary telerehabilitation on the 6MWT, CET and three of four CRQ domains, none of these improvements were maintained after 6 months and scores returned to their baseline values (all p values > 0.05 when comparing T3 with T1). While pulmonary telerehabilitation is possible and has a positive impact on patients with moderate to very severe COPD, improvements were not maintained in the long-term even when physical therapy was accompanied by self-management education.01/2014; 6(2):21-30. DOI:10.5195/ijt.2014.6156
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ABSTRACT: Systemic inflammation is associated with chronic obstructive pulmonary disease (COPD) and many other chronic diseases. It is increasingly recognized that individuals with COPD frequently have underlying comorbidities including cardiovascular disease, skeletal muscle dysfunction, depression and anxiety, obstructive sleep apnea, osteoporosis, gastroesophageal reflux disease, anemia, lung cancer, cognitive impairment, diabetes, renal insufficiency, and chronic infections. The link between systemic inflammation, COPD, and its common comorbidities is incompletely understood. However, persons with COPD and comorbidities have a reduced quality of life and functional status, utilize more health care resources, and are at higher risk of hospitalization and death. Screening for and treating comorbidities are important in the integrated care of the COPD patient and may have a substantial impact on morbidity and mortality.Clinical Pulmonary Medicine 01/2014; 21(4):155-166. DOI:10.1097/CPM.0000000000000044
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ABSTRACT: In 2015, the Patient Protection and Affordable Care Act of 2010 will mandate reduced Medicare reimbursements for hospitals with Chronic Obstructive Pulmonary Disease (COPD) readmissions that are higher than expected. Several studies identified social issues as a concern and possible contributor to readmissions. This study calculated readmission rates for patients with COPD following an enhanced psychosocial assessment. With 26 participants serving as their own historical controls, a paired t-test of the mean of admissions 90 days prior to the assessment and 90 days postassessment was conducted. The study group had a significantly lower number of readmissions in the 90 days postintervention.Social Work in Health Care 03/2015; 54(3):234-51. DOI:10.1080/00981389.2015.1005269 · 0.62 Impact Factor