Self-management: personalized action plans for COPD exacerbations

Evidence suggests that self-management interventions have positive effects on HRQoL and hospitalization rates in patients with chronic obstructive pulmonary disease (COPD). A COPD exacerbation action plan, defining actions that patients should take if respiratory symptoms deteriorate, is seen as an integral part of a COPD self-management intervention with benefits arising from earlier initiation of appropriate treatment, decreasing the severity of exacerbations, accelerating recovery, and reducing healthcare utilization. There is no evidence for the effects of using a sole COPD exacerbation action plan, but a growing evidence for the effectiveness of action plans integrated in COPD self-management interventions. Specific patient training in the use of a COPD exacerbation action plan by case-managers with reinforcement of self-management skills seems to be essential. Before introducing the action plan and training, patients’ current level of readiness should be assessed and potential barriers for the use of, and adherence to, COPD exacerbation action plans (e.g., health literacy and comorbidities) should be considered. COPD exacerbation action plans and training should be tailored accordingly.