Development of a self-treatment approach for patients with COPD and comorbidities: an ongoing learning process

Tanja Effing, Anke Lenferink, Julie Buckman, Deborah Spicer, Paul Cafarella, Morton G. Burt, Katherine L. Bassett, C. van Ommeren, Sally Anesbury, Paul D.L.P.M. van der Valk, Peter A. Frith, Job van der Palen

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Abstract

Background: Patient-initiated action plans are an important component of COPD self-management (SM) interventions. When integrated into SM interventions, these action plans have proven to be effective in reducing exacerbation severity, hospitalisations, and costs and in improving health status in patients with COPD without severe comorbidities. Because of overlap in symptoms, a self-treatment (ST) approach that focuses solely on traditional symptoms of COPD is inadequate for patients with COPD and comorbidities. The COPE-III SM intervention combines (I) patient-initiated action plans that are tailored to the individual’s co-morbid disease(s), and (II) ongoing nurse support. In this paper we provide information regarding the integration of information from two previous COPD SM studies (COPE I and II) in the development of the current COPE-III ST approach. Materials and methods: COPE-III ST materials include daily symptom diaries and action plans that take patient’s common comorbidities [chronic heart failure (CHF), anxiety, depression, ischaemic heart disease (IHD), and diabetes] into account. The comorbid diary and action plans components were developed in collaboration with multiple disease-experts. Results: Previous SM studies have highlighted some essential topics that need to be considered when developing a SM or ST approach: ‘when to initiate ST’, ‘how to optimize materials and safety’, and ‘how to achieve behavioural change’. In the COPE-III study, ST is initiated after a significant change in symptoms. This is consistent with the COPE-II approach and was implemented because disease symptoms are often present even when patients are stable. We have tried to ensure patient safety by providing an easily accessible case-manager to patients throughout their involvement in the study. Furthermore, a psychologist has ensured the use of behavioural change techniques throughout the intervention. Conclusions: We should continue to learn from our experiences with SM interventions to further optimize future SM and ST interventions. The use of materials that are suitable for different levels of patient literacy and the training of health care providers are other points of improvement.
Original languageEnglish
Pages (from-to)1597-1605
JournalJournal of thoracic disease
Volume6
Issue number11
DOIs
Publication statusPublished - 2014

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Self Care
Chronic Obstructive Pulmonary Disease
Comorbidity
Learning
Therapeutics
Patient Safety
Health Personnel
Health Status
Myocardial Ischemia
N-succinyl-1,2-dioleoylphosphatidylethanolamine
Hospitalization
Anxiety
Heart Failure
Nurses
Depression
Psychology
Safety
Costs and Cost Analysis

Keywords

  • IR-93429
  • METIS-307582

Cite this

Effing, Tanja ; Lenferink, Anke ; Buckman, Julie ; Spicer, Deborah ; Cafarella, Paul ; Burt, Morton G. ; Bassett, Katherine L. ; van Ommeren, C. ; Anesbury, Sally ; van der Valk, Paul D.L.P.M. ; Frith, Peter A. ; van der Palen, Job. / Development of a self-treatment approach for patients with COPD and comorbidities: an ongoing learning process. In: Journal of thoracic disease. 2014 ; Vol. 6, No. 11. pp. 1597-1605.
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abstract = "Background: Patient-initiated action plans are an important component of COPD self-management (SM) interventions. When integrated into SM interventions, these action plans have proven to be effective in reducing exacerbation severity, hospitalisations, and costs and in improving health status in patients with COPD without severe comorbidities. Because of overlap in symptoms, a self-treatment (ST) approach that focuses solely on traditional symptoms of COPD is inadequate for patients with COPD and comorbidities. The COPE-III SM intervention combines (I) patient-initiated action plans that are tailored to the individual’s co-morbid disease(s), and (II) ongoing nurse support. In this paper we provide information regarding the integration of information from two previous COPD SM studies (COPE I and II) in the development of the current COPE-III ST approach. Materials and methods: COPE-III ST materials include daily symptom diaries and action plans that take patient’s common comorbidities [chronic heart failure (CHF), anxiety, depression, ischaemic heart disease (IHD), and diabetes] into account. The comorbid diary and action plans components were developed in collaboration with multiple disease-experts. Results: Previous SM studies have highlighted some essential topics that need to be considered when developing a SM or ST approach: ‘when to initiate ST’, ‘how to optimize materials and safety’, and ‘how to achieve behavioural change’. In the COPE-III study, ST is initiated after a significant change in symptoms. This is consistent with the COPE-II approach and was implemented because disease symptoms are often present even when patients are stable. We have tried to ensure patient safety by providing an easily accessible case-manager to patients throughout their involvement in the study. Furthermore, a psychologist has ensured the use of behavioural change techniques throughout the intervention. Conclusions: We should continue to learn from our experiences with SM interventions to further optimize future SM and ST interventions. The use of materials that are suitable for different levels of patient literacy and the training of health care providers are other points of improvement.",
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author = "Tanja Effing and Anke Lenferink and Julie Buckman and Deborah Spicer and Paul Cafarella and Burt, {Morton G.} and Bassett, {Katherine L.} and {van Ommeren}, C. and Sally Anesbury and {van der Valk}, {Paul D.L.P.M.} and Frith, {Peter A.} and {van der Palen}, Job",
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Effing, T, Lenferink, A, Buckman, J, Spicer, D, Cafarella, P, Burt, MG, Bassett, KL, van Ommeren, C, Anesbury, S, van der Valk, PDLPM, Frith, PA & van der Palen, J 2014, 'Development of a self-treatment approach for patients with COPD and comorbidities: an ongoing learning process', Journal of thoracic disease, vol. 6, no. 11, pp. 1597-1605. https://doi.org/10.3978/j.issn.2072-1439.2014.11.14

Development of a self-treatment approach for patients with COPD and comorbidities: an ongoing learning process. / Effing, Tanja; Lenferink, Anke ; Buckman, Julie; Spicer, Deborah; Cafarella, Paul; Burt, Morton G.; Bassett, Katherine L.; van Ommeren, C.; Anesbury, Sally; van der Valk, Paul D.L.P.M.; Frith, Peter A.; van der Palen, Job.

In: Journal of thoracic disease, Vol. 6, No. 11, 2014, p. 1597-1605.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - Development of a self-treatment approach for patients with COPD and comorbidities: an ongoing learning process

AU - Effing, Tanja

AU - Lenferink, Anke

AU - Buckman, Julie

AU - Spicer, Deborah

AU - Cafarella, Paul

AU - Burt, Morton G.

AU - Bassett, Katherine L.

AU - van Ommeren, C.

AU - Anesbury, Sally

AU - van der Valk, Paul D.L.P.M.

AU - Frith, Peter A.

AU - van der Palen, Job

PY - 2014

Y1 - 2014

N2 - Background: Patient-initiated action plans are an important component of COPD self-management (SM) interventions. When integrated into SM interventions, these action plans have proven to be effective in reducing exacerbation severity, hospitalisations, and costs and in improving health status in patients with COPD without severe comorbidities. Because of overlap in symptoms, a self-treatment (ST) approach that focuses solely on traditional symptoms of COPD is inadequate for patients with COPD and comorbidities. The COPE-III SM intervention combines (I) patient-initiated action plans that are tailored to the individual’s co-morbid disease(s), and (II) ongoing nurse support. In this paper we provide information regarding the integration of information from two previous COPD SM studies (COPE I and II) in the development of the current COPE-III ST approach. Materials and methods: COPE-III ST materials include daily symptom diaries and action plans that take patient’s common comorbidities [chronic heart failure (CHF), anxiety, depression, ischaemic heart disease (IHD), and diabetes] into account. The comorbid diary and action plans components were developed in collaboration with multiple disease-experts. Results: Previous SM studies have highlighted some essential topics that need to be considered when developing a SM or ST approach: ‘when to initiate ST’, ‘how to optimize materials and safety’, and ‘how to achieve behavioural change’. In the COPE-III study, ST is initiated after a significant change in symptoms. This is consistent with the COPE-II approach and was implemented because disease symptoms are often present even when patients are stable. We have tried to ensure patient safety by providing an easily accessible case-manager to patients throughout their involvement in the study. Furthermore, a psychologist has ensured the use of behavioural change techniques throughout the intervention. Conclusions: We should continue to learn from our experiences with SM interventions to further optimize future SM and ST interventions. The use of materials that are suitable for different levels of patient literacy and the training of health care providers are other points of improvement.

AB - Background: Patient-initiated action plans are an important component of COPD self-management (SM) interventions. When integrated into SM interventions, these action plans have proven to be effective in reducing exacerbation severity, hospitalisations, and costs and in improving health status in patients with COPD without severe comorbidities. Because of overlap in symptoms, a self-treatment (ST) approach that focuses solely on traditional symptoms of COPD is inadequate for patients with COPD and comorbidities. The COPE-III SM intervention combines (I) patient-initiated action plans that are tailored to the individual’s co-morbid disease(s), and (II) ongoing nurse support. In this paper we provide information regarding the integration of information from two previous COPD SM studies (COPE I and II) in the development of the current COPE-III ST approach. Materials and methods: COPE-III ST materials include daily symptom diaries and action plans that take patient’s common comorbidities [chronic heart failure (CHF), anxiety, depression, ischaemic heart disease (IHD), and diabetes] into account. The comorbid diary and action plans components were developed in collaboration with multiple disease-experts. Results: Previous SM studies have highlighted some essential topics that need to be considered when developing a SM or ST approach: ‘when to initiate ST’, ‘how to optimize materials and safety’, and ‘how to achieve behavioural change’. In the COPE-III study, ST is initiated after a significant change in symptoms. This is consistent with the COPE-II approach and was implemented because disease symptoms are often present even when patients are stable. We have tried to ensure patient safety by providing an easily accessible case-manager to patients throughout their involvement in the study. Furthermore, a psychologist has ensured the use of behavioural change techniques throughout the intervention. Conclusions: We should continue to learn from our experiences with SM interventions to further optimize future SM and ST interventions. The use of materials that are suitable for different levels of patient literacy and the training of health care providers are other points of improvement.

KW - IR-93429

KW - METIS-307582

U2 - 10.3978/j.issn.2072-1439.2014.11.14

DO - 10.3978/j.issn.2072-1439.2014.11.14

M3 - Article

VL - 6

SP - 1597

EP - 1605

JO - Journal of thoracic disease

JF - Journal of thoracic disease

SN - 2072-1439

IS - 11

ER -