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A self-management programme for COPD: a randomised controlled trial

Katy E. Mitchell, Vicki Johnson-Warrington, Lindsay D. Apps, John Bankart, Louise Sewell, Johanna E. Williams, Karen Rees, Kate Jolly, Michael Steiner, Mike Morgan, Sally J. Singh
European Respiratory Journal 2014 44: 1538-1547; DOI: 10.1183/09031936.00047814
Katy E. Mitchell
1Centre for Exercise and Rehabilitation Science, Leicester Respiratory Biomedical Research Unit, University Hospitals Leicester NHS Trust, Leicester, UK
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  • For correspondence: katy.mitchell@uhl-tr.nhs.uk
Vicki Johnson-Warrington
1Centre for Exercise and Rehabilitation Science, Leicester Respiratory Biomedical Research Unit, University Hospitals Leicester NHS Trust, Leicester, UK
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Lindsay D. Apps
1Centre for Exercise and Rehabilitation Science, Leicester Respiratory Biomedical Research Unit, University Hospitals Leicester NHS Trust, Leicester, UK
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John Bankart
2Keele University, Keele, UK
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Louise Sewell
1Centre for Exercise and Rehabilitation Science, Leicester Respiratory Biomedical Research Unit, University Hospitals Leicester NHS Trust, Leicester, UK
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Johanna E. Williams
1Centre for Exercise and Rehabilitation Science, Leicester Respiratory Biomedical Research Unit, University Hospitals Leicester NHS Trust, Leicester, UK
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Karen Rees
3Warwick Medical School, University of Warwick, Coventry, UK
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Kate Jolly
4School of Health and Population Sciences, University of Birmingham, Edgbaston, UK
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Michael Steiner
1Centre for Exercise and Rehabilitation Science, Leicester Respiratory Biomedical Research Unit, University Hospitals Leicester NHS Trust, Leicester, UK
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Mike Morgan
1Centre for Exercise and Rehabilitation Science, Leicester Respiratory Biomedical Research Unit, University Hospitals Leicester NHS Trust, Leicester, UK
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Sally J. Singh
1Centre for Exercise and Rehabilitation Science, Leicester Respiratory Biomedical Research Unit, University Hospitals Leicester NHS Trust, Leicester, UK
5Coventry University, Coventry, UK
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Abstract

Studies of programmes of self-management support for chronic obstructive pulmonary disease (COPD) have been inconclusive. The Self-Management Programme of Activity, Coping and Education (SPACE) FOR COPD is a 6-week self-management intervention for COPD, and this study aimed to evaluate the effectiveness of this intervention in primary care.

A single-blind randomised controlled trial recruited people with COPD from primary care and randomised participants to receive usual care or SPACE FOR COPD. Outcome measures were performed at baseline, 6 weeks and 6 months. The primary outcome was symptom burden, measured by the self-reported Chronic Respiratory Questionnaire (CRQ-SR) dyspnoea domain. Secondary outcomes included other domains of the CRQ-SR, shuttle walking tests, disease knowledge, anxiety, depression, self-efficacy, smoking status and healthcare utilisation.

184 people with COPD were recruited and randomised. At 6 weeks, there were significant differences between groups in CRQ-SR dyspnoea, fatigue and emotion scores, exercise performance, anxiety, and disease knowledge. At 6 months, there was no between-group difference in change in CRQ-SR dyspnoea. Exercise performance, anxiety and smoking status were significantly different between groups at 6 months, in favour of the intervention.

This brief self-management intervention did not improve dyspnoea over and above usual care at 6 months; however, there were gains in anxiety, exercise performance, and disease knowledge.

Abstract

A brief self-management programme for COPD improves some patient outcomes; however, more support may be required http://ow.ly/AbCpm

Footnotes

  • This article has supplementary material available from erj.ersjournals.com

  • Clinical trial: This study is registered as www.controlled-trials.com with identifier number ISRCTN35501175

  • Support statement: This research was funded by the National Institute for Health Research (NIHR) Research for Patient Benefit Programme (grant PB-PG-0808-17146), and Leicestershire, Northamptonshire and Rutland Collaboration for Leadership in Applied Health Research and Care, and took place at University Hospitals of Leicester National Health Service (NHS) Trust. Support was also provided by the NIHR Leicester Respiratory Biomedical Research Unit. The views expressed are those of the authors and not necessarily those of the NHS, the NIHR or the Department of Health.

  • Conflict of interest: Disclosures can be found alongside the online version of this article at erj.ersjournals.com

  • Received March 12, 2014.
  • Accepted July 28, 2014.
  • ©ERS 2014
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A self-management programme for COPD: a randomised controlled trial
Katy E. Mitchell, Vicki Johnson-Warrington, Lindsay D. Apps, John Bankart, Louise Sewell, Johanna E. Williams, Karen Rees, Kate Jolly, Michael Steiner, Mike Morgan, Sally J. Singh
European Respiratory Journal Dec 2014, 44 (6) 1538-1547; DOI: 10.1183/09031936.00047814

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A self-management programme for COPD: a randomised controlled trial
Katy E. Mitchell, Vicki Johnson-Warrington, Lindsay D. Apps, John Bankart, Louise Sewell, Johanna E. Williams, Karen Rees, Kate Jolly, Michael Steiner, Mike Morgan, Sally J. Singh
European Respiratory Journal Dec 2014, 44 (6) 1538-1547; DOI: 10.1183/09031936.00047814
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