Document Detail


Internet-based dyspnea self-management support for patients with chronic obstructive pulmonary disease.
MedLine Citation:
PMID:  23073395     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
CONTEXT: People with chronic obstructive pulmonary disease experience dyspnea with activities despite optimal medical management.
OBJECTIVES: The purpose of this study was to test the efficacy of two 12-month dyspnea self-management programs (DSMPs), Internet-based (eDSMP) and face-to-face (fDSMP), compared with a general health education (GHE) control on the primary outcome of dyspnea with activities.
METHODS: Participants with chronic obstructive pulmonary disease were randomized to eDSMP (n=43), fDSMP (n=41), or GHE (n=41). The content of the DSMPs were similar and focused on education, skills training, and coaching on dyspnea self-management strategies, including exercise, and only differed in the delivery mode. Dyspnea with activities was measured with the Chronic Respiratory Questionnaire at three, six, and 12 months. Secondary outcomes included exercise behavior and performance, health-related quality of life, self-efficacy for dyspnea management, and perception of support for exercise. The study was registered at Clinicaltrials.gov (NCT00461162).
RESULTS: There were no differences in dyspnea with activities across groups over 12 months (P=0.48). With the exception of arm endurance (P=0.04), exercise behavior, performance, and health-related quality of life did not differ across groups (P>0.05). Self-efficacy for managing dyspnea improved for the DSMPs compared with GHE (P=0.06). DSMP participants perceived high levels of support for initiating and maintaining an exercise program.
CONCLUSION: The DSMPs did not significantly reduce dyspnea with activities compared with attention control. However, the high participant satisfaction with the DSMPs combined with positive changes in other outcomes, including self-efficacy for managing dyspnea and exercise behavior, highlight the need for additional testing of individually tailored technology-enabled interventions to optimize patient engagement and improve clinically relevant outcomes.
Authors:
Huong Q Nguyen; DorAnne Donesky; Lynn F Reinke; Seth Wolpin; Lawrence Chyall; Joshua O Benditt; Steven M Paul; Virginia Carrieri-Kohlman
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2012-10-13
Journal Detail:
Title:  Journal of pain and symptom management     Volume:  46     ISSN:  1873-6513     ISO Abbreviation:  J Pain Symptom Manage     Publication Date:  2013 Jul 
Date Detail:
Created Date:  2013-07-15     Completed Date:  2014-01-24     Revised Date:  2014-07-02    
Medline Journal Info:
Nlm Unique ID:  8605836     Medline TA:  J Pain Symptom Manage     Country:  United States    
Other Details:
Languages:  eng     Pagination:  43-55     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Dyspnea / physiopathology,  therapy*
Exercise Therapy
Female
Health Education
Humans
Internet*
Male
Middle Aged
Patient Satisfaction
Physical Endurance / physiology
Pulmonary Disease, Chronic Obstructive / physiopathology,  therapy*
Quality of Life
Questionnaires
Respiratory Function Tests
Self Care*
Self Efficacy
Treatment Outcome
Vital Capacity / physiology
Grant Support
ID/Acronym/Agency:
1KL2RR025015/RR/NCRR NIH HHS; 1UL1 RR025014/RR/NCRR NIH HHS; KL2 RR025015/RR/NCRR NIH HHS; M01 RR000037/RR/NCRR NIH HHS; M01 RR000079/RR/NCRR NIH HHS; MO1 RR-00079/RR/NCRR NIH HHS; MO1-RR-000037/RR/NCRR NIH HHS; R01 NR008938/NR/NINR NIH HHS; R01 NR008938/NR/NINR NIH HHS; UL1 RR025014/RR/NCRR NIH HHS
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