2007 OPEN FORUM Abstracts
EFFECTIVENESS OF A STRUCTURED EDUCATION PROGRAM FOR PATIENTS WITH COPD.
S. Semenyuk1, A. Belevskiy1
Background: In contrast to other chronic diseases, such as bronchial asthma, the role of patient education in the management of COPD still remains unclear. Also, priority methods of education are not determinate for patients with COPD. Studies have shown a less efficiency of education initiatives without a physical training program.
Material and Method: 89 patients stage II, III and IV of COPD (GOLD 2003) under outpatient conditions were included in this trial. 75 patients were randomized in to four groups according to methods of the education (individual or small group and with physical training program or alone) and 14 patients of control group received the usual general advice. All patients underwent the following tests: pulmonary function test, 6-MWT, dyspnea score. Measurements were carried on baseline, 1 month, 6 month and 1 year after education course. The numbers of hospital admissions, exacerbations and 24h access to the hospital were registered. The main teaching items of the program are: self-control of typical symptoms; self-management skills; strategies to help minimize dyspnea; effects and side effects of the medication; correct inhalation technique; advice about when to seek doctor; self-management and decision-making process during exacerbations.
Results: The number of 24h access to the hospital was reduced in total groups with the structured education program after 1 year (group education alone – 39,1%, individual method with the fitness program – 56,2%). The total number of hospital admissions and the exacerbations did not change significantly, but a severity of exacerbations was decreased. The education program alone doesn’t changed pulmonary function indices (FVC, FEV1), walking distance and dyspnea significantly. But the education with the physical training program increased the walking performance, and reduced shortness of breath severity. Additional effects were an improvement of the knowledge of the patients about self-control of the disease, the effects and side effects of the medication. The efficacy of the education program is still evident 1 year after the training. In comparison to the results 6 month after the program we found a loss of efficacy.
Conclusion: A structured education program is an essential part of management of patients with COPD. The most effective is the individual method of education with the physical training program. These positive effects are leveled eventually.