Can the COPD web be used to promote self-management in patients with COPD in swedish primary care: a controlled pragmatic pilot trial with 3 month- and 12 month follow-up

Abstract

Objective: Evaluate the feasibility of the COPD Web and its study design and study procedures and to increase the understanding of the potential effect of the tool in order to provide guidance for a future large scale trial. Design: Parallel-group controlled pragmatic pilot trial. Subjects: There was a total of 83 patients with COPD (mean age 70 ± 8 years with a forced expiratory volume in first second percent predicted of 60 ± 17%). The intervention group ( n = 43) was introduced to and had access to the COPD Web in addition to usual care, while the control group ( n = 40) received usual care alone. Main outcome measures: The feasibility of the COPD Web (i.e., if and how the COPD Web was used) was automatically collected through the website, while outcomes on health, conceptual knowledge, and physical activity (PA) were collected through questionnaires at baseline, 3 months and 12 months. Results: At 3 months, 77% of the intervention group was considered users, and the majority of time spent on the site was related to PA and exercises and was spent during the first month (>80%). In addition, the intervention group reported increased PA (odds ratio [OR] = 4.4, P < .001), increased conceptual knowledge in five domains (OR = 2.6–4.2, all P < .05), and altered disease management strategies (e.g., increased PA) (OR ≥ 2.7 P < .05) in comparison to the control group. The latter was also different between groups at 12 months (OR = 3.7, P = .044). Knowledge of PA was correlated with level of PA ( ρ = .425–.512, P < .05) as well as to the use of PA as a strategy to manage their disease ( χ 2 = 11.2–32.9, P < .05). Conclusion: Giving patients with COPD access to the COPD Web in addition to their ordinary primary care might be an effective shorter term (3 month) strategy to promote self-management. However, these results needs to be confirmed in a definitive large-scale trial. Key points Even though self-management strategies are an important part of chronic obstructive pulmonary disease (COPD) management, access to support for such strategies are limited for a large part of the COPD-population. Promoting self-management through the COPD Web might increase short-term levels of physical activity, promote conceptual knowledge and alter disease management strategies. The primary care COPD population in this study experienced limited impact of the disease in daily life, limited exertional dyspnea, and high generic quality-of-life, but vastly reduced levels of physical activity. A future large scale study should include strategies to encourage gr...

Weak smoking cessation awareness in primary health care before surgery: a real-world, retrospective cohort study

“…This could be a feasible approach in the preoperative smoking cessation context as well, taking into account the GP shortage in primary health care. Web-based patient information and support is another solution that has shown promising care results among COPD patients after three months of follow-up [19].…”

Web-based support for self-management strategies versus usual care for people with COPD in primary healthcare: a protocol for a randomised, 12-month, parallel-group pragmatic trial

“…Currently, despite its proven effectiveness, access to self-management interventions is limited2 14 and alternative ways of promoting self-management for people with COPD are warranted. A recent pilot trial has shown that giving people with COPD access to the COPD Web may be an effective short-term strategy to promote self-management that increase levels of PA, promote conceptual knowledge and alter disease management strategies 24. However, these results need to be confirmed in a definitive large-scale randomised trial, including both short-term and long-term evaluation.…”

“…Guided by the pilot study, prompts will be used to encourage the use of the website during the intervention period 24. The reminders will provide information with referral links that will appear in a predefined way.…”

Self-management strategy in training programs for patients with chronic obstructive pulmonary disease

“…2129-2139, https:// doi.org/10.2147/COPd.S136216. Nyberg, A., Tistad, M. and Wadell, K. (2019), "Can the COPd web be used to promote self-management in patients with COPd in 29. swedish primary care: a controlled pragmatic pilot trial with 3 month-and 12 month follow-up", Scandinavian Journal of Primary Health Care, Taylor and Francis Ltd, 37 (1) Аннотация. Екатерина Тимрук-Скоропад., Юлия Павлова, Надежда Сыдорык.…”

“…1939-1947://doi.org/10.2147/COPd.S104728. Sohanpal, R.,Epiphaniou, E. and Taylor, S. (2014), "Self-management for COPd? : why does it generate negative connotations?…”