Researchers from the University of Applied Sciences Utrecht, in The Netherlands, recently reported that many patients with chronic obstructive pulmonary disease (COPD) do not easily engage in self-management of the condition.
While the study “Determinants of activation for self-management in patients with COPD,” published in the International Journal of Chronic Obstructive Pulmonary Disease, identified factors such as anxiety and disease severity as obstacles for self motivated engagement, more research is needed to better understand the intricate mechanisms that could change patient attitudes.
Studies showed that self-management can potentially improve disease and health-related quality of life for patients with many conditions including COPD, but patients often fail to respond to interventions trying to improve self-care, or they fail to comply with the intervention.
From a clinical perspective, the patient’s knowledge, skills, and confidence determines the level of activation toward self-management, or the capacity to manage one’s own disease.
Knowing what factors prevent patients from engaging in self-management could open doors to interventions targeting those specific factors, and also make it easier for physicians to identify patients in need of more support.
A group of 290 COPD patients allowed their medical charts to be examined by the research team, and answered a set of questionnaires that measured their capacity for self-care. About 23% of the patients assessed were deemed to have a poor capacity for self-management; only 14.5% had a high capacity.
Further analyses showed that anxiety, a negative view of one’s illness, higher body weight, older age, and more severe disease were linked to the patients’ capacity to self-manage.Researchers also noted that anxiety was linked to depression and poor mental health status, indicating that emotional distress might present a general obstacle to engagement.
The presence of other diseases in some patients was linked to better ability to self-manage, which researchers suggested might occur because those patients are more experienced in dealing with healthcare situations.
While some factors pointed toward obstacles patients might encounter, the analysis could only explain 17% of the differences for self managing COPD, which made it obvious to the researchers that factors not explored in the study also contribute.