Dating with copd
Smoking is a major cause of COPD, and smoking cessation has been shown to be beneficial in maintaining better lung function and in slowing disease progression across all severity levels.1314 Reduced physical activity level is an independent risk factor for exacerbations, hospital stays, and mortality among those with COPD and occurs even in the early stages of disease.151617 Inhaler treatments have well established efficacy in reducing exacerbations and admissions among patients with moderate and severe COPD, and growing evidence of efficacy in improving clinical outcomes and reducing decline in lung function among patients with more mild impairment.1819 Any intervention that improves medication adherence and inhaler use technique, which is frequently poor,20 is thus likely to improve outcomes for patients.Sixty per cent of primary care patients with COPD report exacerbations of their disease,10 which are associated with more rapid decline in lung function.14 Interventions that aim to reduce the severity of exacerbations include prompting early recognition of symptoms and rapid use of antibiotics or corticosteroids, or both, either through seeking a primary care appointment or use of a self treatment rescue drug pack.This aimed to support self management in relation to smoking cessation, physical activity increases, correct inhaler use technique, and medication adherence.For those with recurrent exacerbations, it also aimed to improve patient confidence in identifying an exacerbation early in order to start rescue drugs (ie, antibiotics or steroids).Objective To evaluate the effectiveness of telephone health coaching delivered by a nurse to support self management in a primary care population with mild symptoms of chronic obstructive pulmonary disease (COPD).Participants 577 patients with Medical Research Council dyspnoea scale scores of 1 or 2, recruited from primary care COPD registers with spirometry confirmed diagnosis.
The eight nurses attended two days of training and practiced telephone coaching sessions with the research team.
A GENEActiv accelerometer was fitted on their non-dominant wrist, which they were asked to return by post in a prepaid envelope after seven days of continuous wear.
This was a pragmatic trial with no constraints on doctors’ management of the participants in either group.
After informed consent, post-bronchodilator spirometry was undertaken, height and weight were measured, and the patient was asked to complete a baseline questionnaire pack.
This questionnaire pack included questions on patient demographics and the measures for the primary and secondary outcomes.