Knowledge and COPD in primary care

Background: Self-management plays a crucial role in the management of chronic obstructive pulmonary disease (COPD). The 9Self-management Programme of Activity, Coping and Education for Chronic Obstructive Pulmonary Disease9 (or 9SPACE for COPD9) manual is known to be effective when delivered by researchers (1). Aim: To evaluate the effectiveness of the SPACE for COPD manual when delivered in primary care by practice nurses. Methods: COPD patients in primary care recruited from 2 sites in the UK, received a self-management manual following a face-to-face consultation and telephone follow-up support by practice nurses. Primary outcome was the Bristol COPD Knowledge Questionnaire (BCKQ). Secondary outcomes included Hospital Anxiety and Depression Scale (HADS) and COPD Assessment Test (CAT) and Medical research council (MRC) Dyspnoea scale. Outcome measures were performed at baseline, 6 weeks and 6 months. Results: A total of 26 patients (13 male: mean[SD] age 69[±9.5] yrs, FEV1 L 1.99 [±0.8], BMI 27,4 [±5,4]; pack/years 25.2 [±16.9], MRC 3 [±1]), showed at 6 weeks a statistically significant improvement for the BCKQ Total Score [mean change 7.93 (95%CI 3.19-12.67, P=0.003)] and HADS Depression [mean change of -1.36 (95%CI -2.22 to -0.49, P=0.005)]. There were no significant changes in disease knowledge and depression at 6 months. No difference between the 2 sites. Conclusion: This brief intervention seems to improve disease knowledge and decrease depression levels at 6 weeks, although this was not sustained at 6 months. It may be that for long-term improvements, a longer or more intense programme is required. Reference: 1. Katy Mitchell et al. European Respiratory Journal 2014; 44: 1538–1547.