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Educating About Disease Management Improves Health-Related Quality of Life in COPD Patients: Presented at CHEST

By Amanda Strong

MONTREAL, CANADA -- November 4, 2005 -- A health management program aimed at patients with chronic obstructive pulmonary disease (COPD) appears to improve their quality of life, according to a study presented here at the American College of Chest Physicians Annual Meeting (CHEST).

Manon Labrecque, MD, MSc, chest physician and assistant professor, Université de Montréal, Montreal, Quebec, Canada, presented the study's findings in a poster session on November 2^nd.

"It's well known in asthma that we can increase quality of life and decrease use of health resources with patient education, but it is less known with COPD," Dr. Labrecque said. "We wanted to see if a health management program could increase knowledge of the disease and if increasing knowledge of the disease could improve quality of life."

Dr. Labrecque and colleagues enrolled 61 patients with stable COPD who were over 50 years of age and had a smoking history of at least 10 pack years. Subjects attended a weekly 12-hour self-management education program (SMEP) over a 4-week period. The SMEP consisted of teaching a small group of patients how to use an action plan that focuses on self-management of acute exacerbations of COPD symptoms.

The researchers used a Disease Knowledge's Questionnaire (DKQ) to evaluate subjects' understanding of COPD prior to their starting the SMEP program, at completion of the program, and again after 12 months. They also assessed subjects at baseline and again at 3 and 12 months using the Short Form Quality of Life Questionnaire (SF-36) and the St. George's Respiratory Questionnaire (SGRQ), which assesses social functioning, and psychological disturbances resulting from airways disease.

Among the 52 subjects who were deemed to be evaluable, the mean DKQ score increased from 58.2% preprogram to 72.6% immediately after the program (P = .0001) and to 74.1% at month 3 (P = .0001). Knowledge was retained over the course of the year as demonstrated by a mean score of 74.2% at month 12 (P = .0001).

Total SGRQ scores and all domain scores were numerically lower at 3 and 12 months compared to preprogram scores, Dr. Labrecque said. Total SGRQ score was 42.2 preprogram, 38.2 at 3 months (P = .016), and 35.0 at 12 months (P = .001). Reductions in the SGRQ impact domain scores also reached clinical significance, which was maintained through month 12.

Statistically significant improvements were also seen in the global psychological score of the SF-36, which increased from 45.0 at baseline to 50.3 at month 3 (P = .004) and 49.5 at month 12 (P = .03). No significant differences were observed in the global physical activity scores of the SF-36.

Dr. Labrecque and her colleagues concluded that an SMEP can significantly improved health related quality of life in patients with COPD, even in an elderly patient population.

"The results were quite surprising because the average of the patients was 70 years old and the severity of the disease was very severe because the [forced expiratory volume at 1 second] was less than 50% of predicted. But they can learn," said Dr. Labrecque. "They learn about their disease, how the medication works, how to deal with increased shortness of breath, etc. And that improvement is still there at 1 year."

The study investigators suggested that based on these results, physicians and hospitals should consider implementing a similar program as an integral part of the long-term care of patients with COPD, regardless of their age or disease severity. The program does not require specialised resources and health professionals could easily implement it within normal practice.


[Presentation title: Self-Management Education Program for Patients With Chronic Obstructive Pulmonary Disease Has Long Term Effect on Quality of Life Improvement. Poster 316]

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