Impact of action plans on perceived COPD burden

Abstract

ABSTRACT Background: Chronic obstructive pulmonary disease (COPD) significantly increases morbidity, mortality, and healthcare costs. Patients need enhanced resources to improve COPD symptoms, avoid exacerbations, and manage their medications. My COPD Action Plan, a worksheet developed by the American Lung Association (ALA), is designed to help patients develop a personalized self-management plan with their providers. Methods: This QI project, conducted at a rural primary care Federally Qualified Health Center (FQHC) as part of the author's Doctor of Nursing Practice (DNP) program requirements, included patients with COPD. Participants completed a preintervention COPD Assessment Test (CAT) and then, together with their provider, completed a personalized ALA COPD action plan. Office staff followed up with patients weekly for 8 weeks to inquire about their ability to follow their COPD action plans and forwarded patient issues to the primary care provider. Postintervention CAT scores were then obtained at a follow-up office visit. Changes in CAT scores were analyzed using descriptive statistics. Results: Seventeen patients met project requirements, consented to participate, and completed all the steps. Preintervention CAT scores ranged from 11 to 37, with a median score of 31. Postintervention CAT scores ranged from 3 to 28, with a median score of 17. The CAT categories that improved the most were chest tightness, activity limitation, and confidence in leaving the home. Conclusion: This project evaluates how use of the ALA's COPD-centered action plan improves patients' perceived COPD burden and reduces healthcare resource utilization.