A self-management approach using self-initiated action plans for symptoms with ongoing nurse support in patients with Chronic Obstructive Pulmonary Disease (COPD) and comorbidities: the COPE-III study protocol.

Chronic Obstructive Pulmonary Disease (COPD) frequently coexists with other diseases. Whereas COPD action plans are currently part of usual care, they are less suitable and potentially unsafe for use in the presence of comorbidities. This study evaluates whether an innovative treatment approach directed towards COPD and frequently existing comorbidities can reduce COPD exacerbation days. We hypothesise that this approach, which combines self-initiated action plans and nurse support, will accelerate proper treatment actions and lead to better control of deteriorating symptoms. In this multicenter randomised controlled trial we aim to include 300 patients with COPD (GOLD II-IV), and with at least one comorbidity (cardiovascular disease, diabetes, anxiety and/or depression). Patients will be recruited from hospitals in the Netherlands (n = 150) and Australia (n = 150) and will be assigned to an intervention or control group. All patients will learn to complete daily symptom diaries for 12-months. Intervention group patients will participate in self-management training sessions to learn the use of individualised action plans for COPD and comorbidities, linked to the diary. The primary outcome is the number of COPD exacerbation days. Secondary outcomes include hospitalisations, quality of life, self-efficacy, adherence, patient's satisfaction and confidence, health care use and cost data. Intention-to-treat analyses (random effect negative binomial regression and random effect mixed models) and cost-effectiveness analyses will be performed. Prudence should be employed before extrapolating the use of COPD specific action plans in patients with comorbidities. This study evaluates the efficacy of tailored action plans for both COPD and common comorbidities.

Lenferink A ，Frith P ，van der Valk P ，Buckman J ，Sladek R ，Cafarella P ，van der Palen J ，Effing T ... -  《-》

Effect of an action plan with ongoing support by a case manager on exacerbation-related outcome in patients with COPD: a multicentre randomised controlled trial.

Trappenburg JC ，Monninkhof EM ，Bourbeau J ，Troosters T ，Schrijvers AJ ，Verheij TJ ，Lammers JW ... -  《-》

COPD education and cognitive behavioral therapy group treatment for clinically significant symptoms of depression and anxiety in COPD patients: a randomized controlled trial.

Kunik ME ，Veazey C ，Cully JA ，Souchek J ，Graham DP ，Hopko D ，Carter R ，Sharafkhaneh A ，Goepfert EJ ，Wray N ，Stanley MA ... -  《PSYCHOLOGICAL MEDICINE》

Self-management plans in the primary care of patients with chronic obstructive pulmonary disease.

McGeoch GR ，Willsman KJ ，Dowson CA ，Town GI ，Frampton CM ，McCartin FJ ，Cook JM ，Epton MJ ... -  《-》

Does quality of life of COPD patients as measured by the generic EuroQol five-dimension questionnaire differentiate between COPD severity stages?

Rutten-van Mölken MP ，Oostenbrink JB ，Tashkin DP ，Burkhart D ，Monz BU ... -  《CHEST》