Anke Lenferink|Job van der Palen|P.D.L.P.M. van der Valk|Paul Cafarella|Anneke van Veen|Stephen Quinn|Catharina G.M. Groothuis-Oudshoorn|Morton G. Burt|Mary Young|Peter Frith|Tanja Effing
Exacerbation action plans for patients with COPD and comorbidities: a randomised controlled trial
Flinders University|Medisch Spectrum Twente|University of Twente|Medisch Spectrum Twente|University of Twente|Medisch Spectrum Twente|Women's and Children's Health Network|Flinders University|Canisius-Wilhelmina Ziekenhuis|Swinburne University of Technology|University of Twente|Flinders University|Flinders Medical Centre|Royal Adelaide Hospital|Flinders University|Women's and Children's Health Network|Flinders University
international randomised controlled trial evaluated whether copd patients comorbidities trained using patienttailored multidisease exacerbation action plans fewer copd exacerbation days usual care uc copd patients global initiative chronic obstructive lung disease gold classification iiiv 1 comorbidity ischaemic heart disease heart failure diabetes anxiety depression randomised patienttailored selfmanagement intervention n102 uc n99 daily symptom diaries completed 12 months primary outcome copd exacerbation days per patient per year assessed using intentiontotreat analyses significant difference observed number copd exacerbation days per patient per year selfmanagement median 96 interquartile range iqr 07311 uc median 156 iqr 30403 incidence rate ratio irr 087 95 ci 054 139 p0546 significantly shorter duration per copd exacerbation selfmanagement selfmanagement median 81 iqr 48101 days uc median 95 iqr 70151 days p0021 betweengroup differences total number respiratory hospitalisations irr 076 95 ci 042 135 p0348 lower probability 1 respiratoryrelated hospitalisation compared uc relative risk 055 95 ci 035 087 p0008 betweengroup differences observed allcause hospitalisations irr 107 95 ci 066 172 mortality selfmanagement n4 39 uc n7 71 relative risk 055 95 ci 017 184 patienttailored exacerbation action plans copd patients comorbidities significantly reduce exacerbation days reduced duration per copd exacerbation risk least one respiratoryrelated hospitalisation followup without excess allcause mortality