scholarly journals 2294 Do patient comorbidities impact the effectiveness of a COPD self-management program?

2018 ◽  
Vol 2 (S1) ◽  
pp. 41-41
Author(s):  
Emilia Galli Thurber ◽  
Hanan Aboumatar
Keyword(s):  
Quality Of Life ◽  
Patient Outcomes ◽  
The United States ◽  
Management Program ◽  
Emergency Department Visits ◽  
The Self ◽  
Self Management ◽  
Management Intervention ◽  
Comorbidity Burden

OBJECTIVES/SPECIFIC AIMS: Chronic obstructive pulmonary disease (COPD) is a leading cause of both hospitalizations and readmissions in the United States, and about 1 in 5 hospitalized patients with COPD will be readmitted within 30 days. COPD-focused self-management programs are frequently used to help patients better manage their symptoms and prevent hospitalization. However, while the majority of patients with COPD have at least one comorbidity, most trials of COPD self-management programs either excluded patients with significant comorbidities or did not analyze the impact of comorbidities on patient outcomes. Using data from the BREATHE trial of a COPD self-management program, this study aims to determine if patient post-intervention outcomes differ based on the intensity and type of patient comorbidities. METHODS/STUDY POPULATION: In total, 240 patients hospitalized for COPD were randomly assigned to either a comprehensive self-management intervention or usual transitional care. Primary outcomes for this trial were the number of COPD-related hospitalizations and emergency department visits at 6 months and changes in COPD-specific quality of life. To determine whether patient comorbidities modify the effect of the self-management intervention on readmission and quality of life outcomes, we will compare patient outcomes across groups stratified by comorbidity burden (Charlson Comorbidity Index) and type (baseline diagnosis of congestive heart failure, diabetes, and depression). In addition, we will use regression analysis with interaction terms to test for interaction between comorbidity burden/type and intervention assignment. RESULTS/ANTICIPATED RESULTS: We hypothesize that the effect of the self-management intervention will differ in patients with greater comorbidity burden due to competing medical demands for patients with multimorbidity. DISCUSSION/SIGNIFICANCE OF IMPACT: The results of this study will help clinicians better target disease-specific self-management programs to the groups of patients with COPD who are likely to receive the greatest benefit from this type of intervention.

scholarly journals Self-management: A comprehensive approach to improve quality of life among people living with HIV in Indonesia

2021 ◽  
Author(s):  
Achmad Fauzi ◽  
Nofa Anggraini ◽  
Novy Fatkhurohman
Keyword(s):  
Quality Of Life ◽  
Comparison Group ◽  
Management Program ◽  
The Self ◽  
World Health ◽  
Self Management ◽  
People Living With Hiv ◽  
Post Test ◽  
Living With Hiv

Background: People living with HIV (PLWH) today have to deal with a chronic condition that requires efficient self-management due to increased longevity. Self-management interventions have been shown to improve physical and psychological symptoms as well as clinical results in chronic diseases. However, few studies have investigated the effect of self-management on quality of life (QOL) among PLWH in Indonesia. Objective: To examine the effect of a self-management program on QOL among PLWH in Indonesia. Methods: This was a quasi-experiment design with a pre-post-test study with a comparison group in a general hospital in Jakarta. Of the 114 recruited PLWH, 57 were assigned to the intervention group and 57 to the comparison group. The self-management group attended a four-week program workshop. The intervention consisted of five sessions: need assessment and goal setting, maintaining a healthy lifestyle, educational participation to increase communication and self-esteem, and evaluation. The comparison group received standard educational material throughout the leaflet regarding HIV prevention. The post-test assessment was conducted immediately after intervention (T1) and two months (T2) after the intervention in both groups. QoL was measured using the World Health Organization Quality of Life (WHOQOL)-HIV brief Bahasa version. The estimations were obtained using fixed-effect regressions. The differences between T0, T1, and T2 for the intervention and comparison groups were evaluated and compared using the DI Differences method (DID). Results: The self-management program improved outcomes relative to the control at T1 across four outcomes: 1) overall QOL score increased 8.7% (95% CI 0.021–0.149), 2) physical domain saw a modest increased 8.8% (95% CI 0.017–0.125), 3) psychological domain increased 23.5 % (95% CI 0.085–0.689), environmental domain saw a modest increase of 18.7% (95% CI 0.053–0.371). At T2, the total QOL score and the physical, psychological, and environmental dimensions significantly improved compared to the comparison group. Conclusion: The self-management program appears to improve the QOL of the life of PLWH. Nurses are advised to provide PLWH with self-management training. Future research on self-management intervention would need to be refined further to ensure that each community achieves consistent intervention outcomes. Funding: This study was funded by STIKes Abdi Nusantara, Indonesia.

Results on health-related quality of life and functionality of a patient-centered self-management program in hospitalized COPD: a randomized control trial

2019 ◽  
Vol 42 (25) ◽  
pp. 3687-3695 ◽  
Author(s):  
Laura Lopez-Lopez ◽  
Marie Carmen Valenza ◽  
Janet Rodriguez-Torres ◽  
Irene Torres-Sanchez ◽  
Maria Granados-Santiago ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Control Trial ◽  
Management Program ◽  
Self Management ◽  
Health Related Quality ◽  
Patient Centered ◽  
Related Quality ◽  
Health Related ◽  
Randomized Control

scholarly journals Effects of the “Living well with COPD” intervention in primary care: a comparative study

2018 ◽  
Vol 51 (1) ◽  
pp. 1701375 ◽  
Author(s):  
Claudia Steurer-Stey ◽  
Kaba Dalla Lana ◽  
Julia Braun ◽  
Gerben ter Riet ◽  
Milo A. Puhan
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Usual Care ◽  
Self Management ◽  
Health Related Quality ◽  
Management Intervention ◽  
Living Well ◽  
Related Quality ◽  
Health Related

The pivotal objective of chronic obstructive pulmonary disease (COPD) self-management programmes is behaviour change to avoid moderate and severe exacerbations and improve health related quality of life.In a prospectively planned, controlled study, COPD patients who participated in the “Living well with COPD” (LWWCOPD) self-management intervention were compared with usual care patients from the primary care COPD Cohort ICE COLD ERIC, who did not receive self-management intervention (NCT00706602) The primary outcome was behaviour change and disease-specific health related quality of life after 1 year. Secondary end-points included exacerbation rates. We calculated mixed linear, zero-inflated negative binomial and logistic regression models and used propensity scores to counteract confounding.467 patients, 71 from the LWWCOPD and 396 from the usual care cohort, were included. The differences between intervention and control were 0.54 (95% CI 0.13−0.94) on the Chronic Respiratory Questionnaire domain “mastery”, 0.55 (95% CI 0.11−0.99) on “fatigue”, 0.54 (0.14−0.93) on “emotional function” and 0.64 (95% CI 0.14−1.14) on “dyspnoea”. The intervention considerably reduced the risk of moderate and severe exacerbations (incidence rate ratio 0.36, 95% CI 0.25−0.52).Self-management coaching in primary care improves health-related quality of life and lowers exacerbation rates and health care use.

scholarly journals Self-Management Intervention to Improve Self-Care and Quality of Life in Heart Failure Patients

2012 ◽  
Vol 19 (4) ◽  
pp. E9-E16 ◽  
Author(s):  
Heng-Hsin Tung ◽  
Chun-Yu Lin ◽  
Kuei-Ying Chen ◽  
Chien-Jung Chang ◽  
Yu-Ping Lin ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Self Care ◽  
Self Management ◽  
Heart Failure Patients ◽  
Management Intervention

Yoga for Heart Failure Patients: A Feasibility Pilot Study with a Multiethnic Population

2011 ◽  
Vol 21 (1) ◽  
pp. 77-83 ◽  
Author(s):  
Ai Kubo ◽  
Yun-Yi Hung ◽  
Jeffrey Ritterman
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Intervention Program ◽  
Pilot Trial ◽  
The United States ◽  
Management Program ◽  
Primary Study ◽  
Long Term Effects ◽  
Breathing Exercises

Background: Congestive heart failure (CHF) is highly prevalent and the most costly cardiovascular illness in the United States. Yoga is known to be effective in lowering stress, lessening depression, and increasing physical fitness and may be used as an adjuvant management program for CHF patients. Primary Study Objective:To determine the feasibility of a yoga intervention program among a multiethnic CHF population living in underserved neighborhoods. Methods: Uncontrolled intervention trial. Setting: Kaiser Permanente Medical Centers,Richmond and Oakland, California. Participants: 14 CHF patients (7 female), mean age 64 (SD = 6.4) years, and 62% African-American. Intervention: Eight-week, 2x/week, 1-hr yoga classes that included meditation, breathing exercises, gentle yoga poses, and relaxation. Primary outcome measures: The intervention feasibility was measured by recruitment rates, participant retention and adherence. Body weight and self-reported depression and quality of life were measured before and after the intervention. Results: Among the 14 patients enrolled, 13 completed the intervention. Of those who completed the trial, 92% attended at least 50% of the classes. There was a significant reduction in weight (-3.5 lb, p = 0.01) and improvement in the severity of depression (p < 0.05), as well as a trend toward increased quality of life (p = 08). No adverse events were observed. Conclusions: This pilot trial demonstrates that it is feasible for patients with CHF to incorporate yoga into their lifestyle. Yoga may help with routine disease management, prevention of fluid retention, and improvement of depression and quality of life. A larger trial is needed to confirm efficacy and to determine the long-term effects on other important outcomes, such as hospital re-admission rates or prognostic biomarkers.

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