Self-management behaviors to reduce exacerbation impact in COPD patients: a Delphi study

• Published in: International journal of chronic obstructive pulmonary disease Vol. 12; pp. 2735 - 2746
• Main Authors: Korpershoek, Yvonne Jg, Bruins Slot, Joyce C, Effing, Tanja W, Schuurmans, Marieke J, Trappenburg, Jaap Ca
• Format: Journal Article
• Language: English
• Published: New Zealand Dove Medical Press Limited 01-01-2017; Dove Medical Press Ltd; Dove Medical Press
• Subjects: Adult; Aged; Analysis; Care and treatment; Chronic obstructive lung disease; Chronic obstructive pulmonary disease; Consensus; COPD; Data collection; Delphi method; Delphi study; Delphi Technique; Disease Progression; exacerbation; Exercise; Female; Health Behavior; Health Knowledge, Attitudes, Practice; Humans; Literature reviews; Lung - physiopathology; Male; Middle Aged; Mortality; Original Research; Patient outcomes; Physiological aspects; Pulmonary Disease, Chronic Obstructive - diagnosis; Pulmonary Disease, Chronic Obstructive - physiopathology; Pulmonary Disease, Chronic Obstructive - psychology; Pulmonary Disease, Chronic Obstructive - therapy; Quality of life; Self care (Health); Self Care - methods; self-management; Surveys; Time Factors; Treatment Outcome; Validity; Netherlands; Delphi technique and behavior; Delphi study; self-management; self-care; COPD; exacerbation
• ISSN: 1178-2005; 1176-9106; 1178-2005
• DOI: 10.2147/COPD.S138867

Little is known about which self-management behaviors have the highest potential to influence exacerbation impact in COPD patients. We aimed to reach expert consensus on the most relevant set of self-management behaviors that can be targeted and influenced to maximize reduction of exacerbation impact.
A 2-round Delphi study was performed using online surveys to rate the relevance and feasibility of predetermined self-management behaviors identified by literature and expert opinion. Descriptive statistics and qualitative analyses were used.
An international expert panel reached consensus on 17 self-management behaviors focusing on: stable phase (n=5): pharmacotherapy, vaccination, physical activity, avoiding stimuli and smoking cessation; periods of symptom deterioration (n=1): early detection; during an exacerbation (n=5): early detection, health care contact, self-treatment, managing stress/anxiety and physical activity; during recovery (n=4): completing treatment, managing stress/anxiety, physical activity and exercise training; and after recovery (n=2): awareness for recurrent exacerbations and restart of pulmonary rehabilitation.
This study has provided insight into expert opinion on the most relevant and feasible self-management behaviors that can be targeted and influenced before, during and after an exacerbation to exert the highest magnitude of influence on the impact of exacerbations. Future research should focus at developing more comprehensive patient-tailored interventions supporting patients in these exacerbation-related self-management behaviors.