Predictors of patient adherence to COPD self-management exacerbation action plans
| Autor: | Marjolein Brusse-Keizer, Jade Schrijver, Job van der Palen, Anke Lenferink, Paul van der Valk, Tanja W. Effing |
|---|---|
| Přispěvatelé: | Health Technology & Services Research |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Exacerbation Chronic Obstructive Pulmonary Disease Patient adherence Disease law.invention Pulmonary Disease Chronic Obstructive 03 medical and health sciences 0302 clinical medicine Randomized controlled trial law Internal medicine Disease management medicine Humans 030212 general & internal medicine Disease management (health) Randomised controlled trial COPD Self-management business.industry Self-Management 030503 health policy & services General Medicine medicine.disease Comorbidity Self Care Quality of Life Prednisolone Patient Compliance 0305 other medical science business Self-treatment medicine.drug |
| Zdroj: | Patient education and counseling, 104(1), 163-170. Elsevier |
| ISSN: | 0738-3991 |
| Popis: | Objective Identifying patient characteristics predicting categories of patient adherence to Chronic Obstructive Pulmonary Disease (COPD) exacerbation action plans. Methods Data were obtained from self-treatment intervention groups of two COPD self-management trials. Patients with ≥1 exacerbation and/or ≥1 self-initiated prednisolone course during one-year follow-up were included. Optimal treatment was defined as ‘self-initiating prednisolone treatment ≤2 days from the onset of a COPD exacerbation’. Predictors of adherence categories were identified by multinomial logistic regression analysis using patient characteristics. Results 145 COPD patients were included and allocated to four adherence categories: ‘optimal treatment’ (26.2 %), ‘sub optimal treatment’ (11.7 %), ‘significant delay or no treatment’ (31.7 %), or ‘treatment outside the actual exacerbation period’ (30.3 %). One unit increase in baseline dyspnoea score (mMRC scale 0–4) increased the risk of ‘significant delay or no treatment’ (OR 1.64 (95 % CI 1.07−2.50)). Cardiac comorbidity showed a borderline significant increased risk of ‘treatment outside the actual exacerbation period’ (OR 2.40 (95 % CI 0.98−5.85)). Conclusion More severe dyspnoea and cardiac comorbidity may lower adherence to COPD exacerbation action plans. Practice implications Tailored self-management support with more focus on dyspnoea and cardiac disease symptoms may help patients to better act upon increased exacerbation symptoms and improve adherence to COPD exacerbation action plans. |
| Databáze: | OpenAIRE |
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