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. 2011 Sep-Oct;18(5):e77-81.
doi: 10.1155/2011/263574.

Can a self-management education program for patients with chronic obstructive pulmonary disease improve quality of life?

Manon Labrecque  1 , Khalil Rabhi, Catherine Laurin, Helene Favreau, Gregory Moullec, Kim Lavoie, Marcel Julien
Affiliations

Can a self-management education program for patients with chronic obstructive pulmonary disease improve quality of life?

Manon Labrecque et al. Can Respir J. 2011 Sep-Oct.

Abstract
in English, French

Objective: To assess the effects of a self-management program on health-related quality of life (HRQoL) and morbidity commonly associated with chronic obstructive pulmonary disease (COPD).

Methods: A total of 57 outpatients with stable COPD received four weeks of self-management education, while 45 patients received usual care. Patients were evaluated at baseline, at three months and one year following the educational intervention. The primary outcome variable was HRQoL measured by the St George's Respiratory Questionnaire (SGRQ). The secondary outcome variables were number of emergency room visits and hospitalizations for exacerbation.

Results: The intervention group's HRQoL improved significantly at three months (total score A = -5.0 [P = 0.006]) and 12 months (total score A = -6.7 [P < 0.001]), as evidenced by decreased scores on the SGRQ. In contrast, the SGRQ scores increased significantly in the control group at three months (total score A = +3.7 [P = 0.022]) and 12 months (total score A = +3.4 [P = 0.032]). Global impact appeared to be responsible for the change in the intervention group. Moreover, in the intervention group, the number of hospitalizations dropped from 0.7⁄person⁄year to 0.3⁄person⁄year (P = 0.017), and emergency room visits dropped from 1.1 person⁄year to 0.2⁄person⁄year (P = 0.002), while subjects in the control group did not experience any significant decreases in these parameters.

Conclusions: A planned education program improved HRQoL while decreasing the number of emergency room visits and hospitalizations in patients with stable COPD; this improvement persisted at 12 months.

OBJECTIF :: Évaluer les effets d’un programme d’autogestion sur la qualité de vie liée à la santé (QVLS) et sur la morbidité souvent associée à la maladie pulmonaire obstructive chronique (MPOC).

MÉTHODOLOGIE :: Au total, 57 patients en consultations externes ayant une MPOC stable ont reçu une éducation à l’autogestion de quatre semaines, tandis que 45 patients ont reçu les soins habituels. Les patients ont été évalués au départ, puis trois mois et un an après l’intervention d’éducation. La variable d’issue primaire était la QVLS mesurée selon le questionnaire respiratoire de St George (QRSG). Les variables d’issue secondaire étaient le nombre de consultations à l’urgence et d’hospitalisations en raison d’exacerbations.

RÉSULTATS :: La QVLS du groupe d’intervention s’est considérablement améliorée au bout de trois mois (indice total A=−5,0 [P=0,006]) et de 12 mois (indice total A=−6,7 [P<0,001]), tel que le démontre la diminution des indices au QRSG. Par contre, les indices du QRSG ont augmenté de manière significative dans le groupe témoin au bout de trois mois (indice total A=+3,7 [P=0,022]) et de 12 mois (indice total A=+3,4 [P=0,032]). L’impact global semblait être responsable de la modification dans le groupe d’intervention. De plus, dans ce même groupe, le nombre d’hospitalisations a fléchi de 0,7 par personne par année à 0,3 par personne par année (P=0,017), et les consultations à l’urgence sont passées de 1,1 par personne par année à 0,2 par personne par année (P=0,002), tandis que les sujets du groupe témoin ne présentaient aucune diminution significative de ces paramètres.

CONCLUSIONS :: Un programme d’éducation planifié améliorait la QVLS tout en réduisant le nombre de consultations à l’urgence et d’hospitalisations chez les patients atteints d’une MPOC stable. Cette amélioration persistait au bout de 12 mois.

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