Five-year follow-up of a one-year self-management program for patients with COPD.

OBJECTIVE: Investigate long-term effects 4 years after the end of a 1-year self-management program (SMP) with 30 hours of education and 16 hours of physical activity in patients with chronic obstructive pulmonary disease (COPD). METHODS: Prospective observational outcome study. SMP focused on improving disease related self-care skills. Main outcome measures were health-related quality of life, HRQoL, (St Georges Respiratory Questionnaire, SGRQ total) and exercise capacity (6-minute walk test, 6MWT). RESULTS: Thirty patients participated, 47% women. Baseline mean age was 67 years and mean pre-bronchodilator FEV(1) (forced expiratory volume in 1 second) percentage predicted was 41.3. HRQoL showed a statistical significant improvement during the 1-year intervention. Four years after the end of the program SGRQ total was similar to baseline value, 1.4 points (95% CI: -3.6 to 6.3, P = 0.580). Also 6MWT was similar to baseline value at the same test point, -10 m (95% CI: -27 to 8, P = 0.262), and 63% reported having continued to exercise regularly a minimum of three times per week during the follow-up period. CONCLUSION: The participants in a 1-year self-management program with additional training had maintained their pre-intervention level of HRQoL and exercise capacity 4 years after the end of the program. Two out of three participants had continued to exercise regularly.

Observational studies of a one year self-management program and a two year pulmonary rehabilitation program in patients with COPD.

OBJECTIVE: To describe the outcome of a one year self-management program (SMG) and a two year pulmonary rehabilitation program (PRG). METHODS: Two open prospective observational studies with 30 patients in each study. SMG had 46 hours over 12 months. PRG had in addition three weekly exercise sessions parallel which lasted an additional year. RESULTS: In SMG, health-related quality of life (HRQoL, measured by St. George's Respiratory Questionnaire) had an improvement of-3.6 points (95% CI -6.7 to -0.5) one year after the end of the intervention, but there was no change in the six minutes walking test (6MWT). The PRG had an improvement in HRQoL at the end of the intervention of -11.2 points (95% CI -13.9 to -8.4) and the 6MWT was clinically significant improved with 86 metres (95% CI 63 to 109). None of the groups showed any clinical relevant change in lung function. CONCLUSION: Participants in the SMG had had an improvement in quality of life and no deterioration in exercise tolerance one year after the end of the program compared to the start. Participants in the PRG significantly improved their quality of life and exercise tolerance the first year, but had no further clinical relevant improvement the second year.