“Tailored self-management support with more focus on dyspnea and cardiac disease symptoms may help patients to better act upon increased exacerbation symptoms and improve adherence to COPD exacerbation action plans,” write the authors of a study published in Patient Education & Counseling. The researchers obtained data from self-treatment intervention groups of two COPD self-management trials including 145 patients with at least one exacerbation and/or at least one self-initiated prednisolone course during 1-year follow-up. They defined optimal treatment as self-initiating prednisolone within 2 days of COPD exacerbation onset. Patients were grouped by adherence into those with optimal treatment (26.2%), suboptimal treatment (11.7%), significant delay or no treatment (31.7%), or treatment outside the actual exacerbation period (30.3%). One unit increase in baseline dyspnea score (mMRC scale 0-4) increased the risk of significant delay or no treatment (odds ratio [OR], 1.64), whereas cardiac comorbidity showed a borderline significant increased risk of treatment outside the actual exacerbation period (OR, 2.40).
