Efficacy of education of COPD patients

Abstract

This randomized controlled trial was designed to evaluate the efficacy of education of patients with COPD. The principal inclusive criterion was the confirmed stable COPD (GOLD, 2003). We had created an original program of self-efficacy and self-management of COPD patients, which was used in this trial. The education was performed individually or at small groups (3-4 persons) with or without pulmonary rehabilitation. Eighty nine patients were involved in the trial, of them 75 patients were divided into 4 groups according to educating methods and 14 patients not drawn in the educational or rehabilitation programs were included in the control group. The efficacy of this educational program was investigated with a control test of the patients' basic information about the disease. Other parameters evaluated were hospital admission rate, exacerbation rate, need for the emergency care, pulmonary function, 6-min walking distance, dyspnea severity. A health-related quality of life was measured by the SF-36 questionnaire and the St. George's hospital Respiratory Questionnaire (SGRQ). The education of COPD patients reduced the need for the emergency care during the consequent year. It did not change number of hospital admissions and the total number of exacerbations, but increased the rate of mild exacerbations. The educational program alone did not affect pulmonary function (FVC, FEV₁), physical tolerability and dyspnoe but improved the health-related quality of life mainly due to the emotional part. Combination of educational and rehabilitation programs improved physical performance and shortness of breath. We concluded that education should be the essential part of management of patients with COPD. The most effective mode was individual education along with pulmonary rehabilitation but its positive effects were kept up for short time.