A Chronic Obstructive Pulmonary Disease Self-Management Intervention for Improving Patient-Reported Outcomes in Primary Care in Greece

Author:

Tsaousi Filothei1,Bouloukaki Izolde1ORCID,Christodoulakis Antonios12ORCID,Ierodiakonou Despo3ORCID,Tzanakis Nikos4,Tsiligianni Ioanna1ORCID

Affiliation:

1. Department of Social Medicine, School of Medicine, University of Crete, 71500 Heraklion, Greece

2. Department of Nursing, School of Health Sciences, Hellenic Mediterranean University, 71410 Heraklion, Greece

3. Department of Primary Care and Population Health, Medical School, University of Nicosia, 2417 Nicosia, Cyprus

4. Department of Thoracic Medicine, University Hospital of Heraklion, School of Medicine, University of Crete, 71003 Heraklion, Greece

Abstract

Background and Objectives: Self-management programs are essential for increasing COPD patient participation and autonomy in making appropriate decisions about their chronic condition. The present study aimed to assess the impact of COPD self-management interventions on quality of life, functional status, patient education, depression, and anxiety in primary care. Materials and Methods: We conducted a randomized controlled trial recruiting patients with COPD (GOLD A and B) from four primary care centers in Crete, Greece, with one intervention group (n = 40) receiving self-management educational support and one control group (n = 80) receiving usual care. To measure quality of life, functional status, patient education, depression, and anxiety, we used patient-reported outcome measures (PROMs) at baseline and 6 months post-intervention, including the Short-Form Health survey (SF-12), Clinical COPD Questionnaire (CCQ), mMRC, Beck Anxiety Inventory (BAI), Beck Depression Inventory, Health Education Impact Questionnaire (HeiQ), and Health Literacy Questionnaire (HLQ). Results: At the end of the 6-month intervention, most PROMs improved significantly in the intervention group (p < 0.05) but did not show significant changes in the control group. The greatest improvements at follow-up compared to baseline measurements were observed for dyspnea (mMRC—38.6%), anxiety (BAI—35%), depression (BDI—20.2%), COPD health status (CCQ—34.1%), and the actively managing my health subscale of HLQ (23.5%). Conclusions: Our results suggest that a self-management intervention could be an effective strategy for improving PROMs in primary care. Although more research is needed to identify the long-term effects of such interventional programs, policymakers could implement similar programs to improve the overall health of these patients.

Publisher

MDPI AG

Reference59 articles.

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2. WHO (2024, January 12). Chronic Obstructive Pulmonary Disease (COPD), Available online: https://www.who.int/news-room/fact-sheets/detail/chronic-obstructive-pulmonary-disease-(copd).

3. OECD and European Observatory on Health Systems and Policies (2024, January 10). Greece: Country Health Profile. Available online: https://www.oecd-ilibrary.org/social-issues-migration-health/greece-country-health-profile-2021_4ab8ea73-en.

4. Characterisation of exacerbation risk and exacerbator phenotypes in the POET-COPD trial;Beeh;Respir. Res.,2013

5. Exacerbations and health care resource utilization in patients with airflow limitation diseases attending a primary care setting: The PUMA study;Aguirre;Int. J. Chron. Obstruct. Pulmon. Dis.,2016

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