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Semin Respir Crit Care Med 2015; 36(04): 630-638
DOI: 10.1055/s-0035-1556059
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Comprehensive Self-Management Strategies

J. Bourbeau
1   Montreal Chest Institute, McGill University Health Centre, Montréal, Quebec, Canada
2   Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre and McGill University, Montreal, Quebec, Canada
,
K. L. Lavoie
3   Department of Psychology, University of Quebec at Montreal. Montreal, Quebec, Canada
4   Montreal Behavioural Medicine Centre, Research Centre, Hopital du Sacré-Coeur de Montreal, Quebec, Canada
,
M. Sedeno
2   Respiratory Epidemiology and Clinical Research Unit, McGill University Health Centre and McGill University, Montreal, Quebec, Canada
› Author Affiliations
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Publication History

Publication Date:
03 August 2015 (online)

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Abstract

In this article, we provide a review of the literature on self-management interventions and we are giving some thought to how, when, and by whom they should be offered to patients. The present literature based on randomized clinical trials has demonstrated benefits (reduced hospital admissions and improved health status) for chronic obstructive pulmonary disease (COPD) patients undergoing self-management interventions, although there are still problems with the heterogeneity among interventions, study populations, follow-up time, and outcome measures that make generalization difficult in real life. Key to the success, self-management intervention has to target behavior change. Proper self-management support is a basic prerequisite, for example, techniques and skills used by health care providers “case manager” to instrument patients with the knowledge, confidence, and skills required to effectively self-manage their disease. To improve health behaviors and engagement in self-management, self-management interventions need to target enhancing intrinsic motivation to change. This will best be done using client-centered communication (motivational communication) that encourages patients to express what intrinsically motivates them (e.g., consistent with their values or life goals) to adopt certain health behavior, with the goal of helping them overcome their ambivalence about change. Finally, if we want to be able to design and implement self-management interventions that are integrated, coherent, and have a strong likelihood of success, we need to take a more careful look and give more attention at the case manager, the patient (patient evaluation), and the quality assurance.

Keywords

COPD - self-management - behavior change - case manager - quality assurance
 

  • References

  • 1 Effing T, Monninkhof EM, van der Valk PD , et al. Self-management education for patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2007; (4) CD002990
    PubMedSearch in Google Scholar
  • 2 Zwerink M, Brusse-Keizer M, van der Valk PD , et al. Self management for patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2014; 3: CD002990
    PubMedSearch in Google Scholar
  • 3 Fan VS, Gaziano JM, Lew R , et al. A comprehensive care management program to prevent chronic obstructive pulmonary disease hospitalizations: a randomized, controlled trial. Ann Intern Med 2012; 156 (10) 673-683
    CrossrefPubMedSearch in Google Scholar
  • 4 Peytremann-Bridevaux I, Taffe P, Burnand B, Bridevaux PO, Puhan MA. Mortality of patients with COPD participating in chronic disease management programmes: a happy end?. Thorax 2014; 69 (9) 865-866
    CrossrefPubMedSearch in Google Scholar
  • 5 Bucknall CE, Miller G, Lloyd SM , et al. Glasgow supported self-management trial (GSuST) for patients with moderate to severe COPD: randomised controlled trial. BMJ 2012; 344: e1060
    CrossrefPubMedSearch in Google Scholar
  • 6 Bischoff EW, Hamd DH, Sedeno M , et al. Effects of written action plan adherence on COPD exacerbation recovery. Thorax 2011; 66 (1) 26-31
    CrossrefPubMedSearch in Google Scholar
  • 7 Bourbeau J, Julien M, Maltais F , et al; Chronic Obstructive Pulmonary Disease axis of the Respiratory Network Fonds de la Recherche en Santé du Québec. Reduction of hospital utilization in patients with chronic obstructive pulmonary disease: a disease-specific self-management intervention. Arch Intern Med 2003; 163 (5) 585-591
    CrossrefPubMedSearch in Google Scholar
  • 8 Wagner EH, Austin BT, Davis C, Hindmarsh M, Schaefer J, Bonomi A. Improving chronic illness care: translating evidence into action. Health Aff (Millwood) 2001; 20 (6) 64-78
    CrossrefPubMedSearch in Google Scholar
  • 9 Wagner EH, Austin BT, Von Korff M. Organizing care for patients with chronic illness. Milbank Q 1996; 74 (4) 511-544
    CrossrefPubMedSearch in Google Scholar
  • 10 Kottke TE, Battista RN, DeFriese GH, Brekke ML. Attributes of successful smoking cessation interventions in medical practice. A meta-analysis of 39 controlled trials. JAMA 1988; 259 (19) 2883-2889
    CrossrefPubMedSearch in Google Scholar
  • 11 Stott NC, Pill RM. 'Advise yes, dictate no'. Patients' views on health promotion in the consultation. Fam Pract 1990; 7 (2) 125-131
    CrossrefPubMedSearch in Google Scholar
  • 12 Rollnick S, Miller WR, Butler CC. Motivational Interviewing in Health Care: Helping Patients Change Behavior. New York, NY; 2008
    Search in Google Scholar
  • 13 Bodenheimer T, Handley MA. Goal-setting for behavior change in primary care: an exploration and status report. Patient Educ Couns 2009; 76 (2) 174-180
    CrossrefPubMedSearch in Google Scholar
  • 14 McDonald HP, Garg AX, Haynes RB. Interventions to enhance patient adherence to medication prescriptions: scientific review. JAMA 2002; 288 (22) 2868-2879
    CrossrefPubMedSearch in Google Scholar
  • 15 Bundy C. Changing behaviour: using motivational interviewing techniques. J R Soc Med 2004; 97 (Suppl. 44) 43-47
    CrossrefPubMedSearch in Google Scholar
  • 16 Resnicow K, DiIorio C, Soet JE, Ernst D, Borrelli B, Hecht J. Motivational interviewing in health promotion: it sounds like something is changing. Health Psychol 2002; 21 (5) 444-451
    CrossrefPubMedSearch in Google Scholar
  • 17 Deci EL, Ryan RM. Intrinsic Motivation and Self-Determination in Human Behavior. New York, NY: 1985
    CrossrefSearch in Google Scholar
  • 18 McClure JB, Divine G, Alexander G , et al. A comparison of smokers' and nonsmokers' fruit and vegetable intake and relevant psychosocial factors. Behav Med 2009; 35 (1) 14-22
    CrossrefPubMedSearch in Google Scholar
  • 19 Dacey M, Baltzell A, Zaichkowsky L. Older adults' intrinsic and extrinsic motivation toward physical activity. Am J Health Behav 2008; 32 (6) 570-582
    PubMedSearch in Google Scholar
  • 20 Furia AC, Lee RE, Strother ML, Huang TT. College students' motivation to achieve and maintain a healthy weight. Am J Health Behav 2009; 33 (3) 256-263
    PubMedSearch in Google Scholar
  • 21 Satia JA, Galanko JA. Intrinsic and extrinsic motivations for healthful dietary change in African Americans. Am J Health Behav 2007; 31 (6) 643-656
    CrossrefPubMedSearch in Google Scholar
  • 22 Bandura A. Self-efficacy: toward a unifying theory of behavioral change. Psychol Rev 1977; 84 (2) 191-215
    CrossrefPubMedSearch in Google Scholar
  • 23 Ajzen I. The theory of planner behavior. Organ Behav Hum Decision Processes 1991; 50: 179-211
    PubMedSearch in Google Scholar
  • 24 Prochaska JO, Velicer WF. The transtheoretical model of health behavior change. Am J Health Promot 1997; 12 (1) 38-48
    CrossrefPubMedSearch in Google Scholar
  • 25 Lundahl B, Moleni T, Burke BL , et al. Motivational interviewing in medical care settings: a systematic review and meta-analysis of randomized controlled trials. Patient Educ Couns 2013; 93 (2) 157-168
    CrossrefPubMedSearch in Google Scholar
  • 26 Miller WR, Rollnick S. Motivational Interviewing: Preparing People for Change. New York, NY: 2002
    Search in Google Scholar
  • 27 Madson MB, Loignon AC, Lane C. Training in motivational interviewing: a systematic review. J Subst Abuse Treat 2009; 36 (1) 101-109
    CrossrefPubMedSearch in Google Scholar
  • 28 Söderlund LL, Madson MB, Rubak S, Nilsen P. A systematic review of motivational interviewing training for general health care practitioners. Patient Educ Couns 2011; 84 (1) 16-26
    CrossrefPubMedSearch in Google Scholar
  • 29 Jones PW, Quirk FH, Baveystock CM, Littlejohns P. A self-complete measure of health status for chronic airflow limitation. The St. George's Respiratory Questionnaire. Am Rev Respir Dis 1992; 145 (6) 1321-1327
    CrossrefPubMedSearch in Google Scholar
  • 30 Standards for the diagnosis and care of patients with chronic obstructive pulmonary disease (COPD) and asthma. This official statement of the American Thoracic Society was adopted by the ATS Board of Directors, November 1986. Am Rev Respir Dis 1987; 136 (1) 225-244
    CrossrefPubMedSearch in Google Scholar
  • 31 Holland AE, Spruit MA, Troosters T , et al. An official European Respiratory Society/American Thoracic Society technical standard: field walking tests in chronic respiratory disease. Eur Respir J 2014; 44 (6) 1428-1446
    CrossrefPubMedSearch in Google Scholar
  • 32 Devilly GJ, Borkovec TD. Psychometric properties of the credibility/expectancy questionnaire. J Behav Ther Exp Psychiatry 2000; 31 (2) 73-86
    CrossrefPubMedSearch in Google Scholar
  • 33 Williams GC, Freedman ZR, Deci EL. Supporting autonomy to motivate patients with diabetes for glucose control. Diabetes Care 1998; 21 (10) 1644-1651
    CrossrefPubMedSearch in Google Scholar
  • 34 Levesque CS, Williams GC, Elliot D, Pickering MA, Bodenhamer B, Finley PJ. Validating the theoretical structure of the Treatment Self-Regulation Questionnaire (TSRQ) across three different health behaviors. Health Educ Res 2007; 22 (5) 691-702
    PubMedSearch in Google Scholar
  • 35 Marcus BH, Forsyth LH. Motivating People to be Physically Active. Champaign, IL: Human Kinetics Publishers; 2003
    Search in Google Scholar