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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.

Titel:	Internet-based dyspnea self-management support for patients with chronic obstructive pulmonary disease.
Autor/in / Beteiligte Person:	Nguyen, HQ ; Donesky, D ; Reinke, LF ; Wolpin, S ; Chyall, L ; Benditt, JO ; Paul, SM ; Carrieri-Kohlman, V
Link:	Zum Volltext
Zeitschrift:	Journal of pain and symptom management, Jg. 46 (2013-07-01), Heft 1, S. 43
Veröffentlichung:	New York, NY : Elsevier ; <i>Original Publication</i>: [Madison, WI : Dept. of Anesthesiology, University of Wisconsin--Madison, 1986-, 2013
Medientyp:	academicJournal
ISSN:	1873-6513 (electronic)
DOI:	10.1016/j.jpainsymman.2012.06.015
Schlagwort:	Aged Aged, 80 and over Dyspnea physiopathology Exercise Therapy Female Health Education Humans Male Middle Aged Patient Satisfaction Physical Endurance physiology Pulmonary Disease, Chronic Obstructive physiopathology Quality of Life Respiratory Function Tests Self Efficacy Surveys and Questionnaires Treatment Outcome Vital Capacity physiology Dyspnea therapy Internet Pulmonary Disease, Chronic Obstructive therapy Self Care
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication 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. Language: English [J Pain Symptom Manage] 2013 Jul; Vol. 46 (1), pp. 43-55. <i>Date of Electronic Publication: </i>2012 Oct 13. MeSH Terms: Internet* ; Self Care* ; Dyspnea / therapy ; Pulmonary Disease, Chronic Obstructive / therapy ; Aged ; Aged, 80 and over ; Dyspnea / physiopathology ; Exercise Therapy ; Female ; Health Education ; Humans ; Male ; Middle Aged ; Patient Satisfaction ; Physical Endurance / physiology ; Pulmonary Disease, Chronic Obstructive / physiopathology ; Quality of Life ; Respiratory Function Tests ; Self Efficacy ; Surveys and Questionnaires ; Treatment Outcome ; Vital Capacity / physiology References: Chest. 2003 Oct;124(4):1421-9. (PMID: 14555575) ; Telemed J E Health. 2011 May;17(4):254-61. (PMID: 21476945) ; BMJ. 2008 Sep 29;337:a1655. (PMID: 18824488) ; Ann Behav Med. 2003 Aug;26(1):1-7. (PMID: 12867348) ; Health Aff (Millwood). 2001 Nov-Dec;20(6):64-78. (PMID: 11816692) ; Am J Respir Crit Care Med. 2002 Jul 1;166(1):111-7. (PMID: 12091180) ; Arch Intern Med. 2007 Dec 10;167(22):2503-8. (PMID: 18071174) ; JAMA. 2002 Nov 20;288(19):2469-75. (PMID: 12435261) ; J Med Internet Res. 2008 Apr 16;10(2):e9. (PMID: 18417444) ; Chest. 1996 Dec;110(6):1526-35. (PMID: 8989072) ; J Med Internet Res. 2010 Feb 17;12(1):e4. (PMID: 20164043) ; J Cardiopulm Rehabil. 2002 Mar-Apr;22(2):109-21. (PMID: 11984209) ; Am J Med. 2008 Jul;121(7 Suppl):S25-32. (PMID: 18558104) ; Chest. 2002 Apr;121(4):1085-91. (PMID: 11948036) ; Am J Respir Crit Care Med. 2008 Apr 15;177(8):912-27. (PMID: 18390964) ; Eur Respir J. 2008 Sep;32(3):651-9. (PMID: 18508824) ; Int J Chron Obstruct Pulmon Dis. 2009;4:301-13. (PMID: 19750190) ; Thorax. 2001 Dec;56(12):954-9. (PMID: 11713359) ; Med Sci Sports Exerc. 1982;14(5):377-81. (PMID: 7154893) ; Patient Educ Couns. 2002 Oct -Nov;48(2):177-87. (PMID: 12401421) ; Telemed J E Health. 2011 Mar;17(2):95-103. (PMID: 21214399) ; Cochrane Database Syst Rev. 2007 Oct 17;(4):CD002990. (PMID: 17943778) ; Chest. 2011 Aug;140(2):331-342. (PMID: 21273294) ; Am J Manag Care. 2009 May;15(5):313-20. (PMID: 19435399) ; Womens Health. 1995 Summer;1(2):161-75. (PMID: 9373378) ; Heart Lung. 1993 May-Jun;22(3):226-34. (PMID: 8098324) ; Med Care. 1992 Jun;30(6):473-83. (PMID: 1593914) ; Expert Rev Respir Med. 2009 Feb;3(1):21-36. (PMID: 20477280) ; Am J Respir Crit Care Med. 1999 Jan;159(1):321-40. (PMID: 9872857) ; Thorax. 1987 Oct;42(10):773-8. (PMID: 3321537) ; Heart Lung. 2005 Jan-Feb;34(1):51-62. (PMID: 15647734) ; Eur Respir J. 2008 Sep;32(3):637-43. (PMID: 18550610) ; Cochrane Database Syst Rev. 2010 Oct 06;(10):CD007717. (PMID: 20927763) ; J Clin Epidemiol. 1999 Mar;52(3):187-92. (PMID: 10210235) ; J Cardiopulm Rehabil. 2005 Sep-Oct;25(5):275-84. (PMID: 16217231) ; J Am Med Inform Assoc. 2007 May-Jun;14(3):269-77. (PMID: 17329725) Grant Information: M01 RR000079 United States RR NCRR NIH HHS; R01 NR008938 United States NR NINR NIH HHS; 1UL1 RR025014 United States RR NCRR NIH HHS; MO1-RR-000037 United States RR NCRR NIH HHS; MO1 RR-00079 United States RR NCRR NIH HHS; M01 RR000037 United States RR NCRR NIH HHS; UL1 RR025014 United States RR NCRR NIH HHS; KL2 RR025015 United States RR NCRR NIH HHS; 1KL2RR025015 United States RR NCRR NIH HHS Contributed Indexing: Keywords: COPD; Internet; Self-management; cell phone; chronic disease; dyspnea; health behavior; health education; pulmonary disease; self-care; smartphone Molecular Sequence: ClinicalTrials.gov NCT00461162 Entry Date(s): Date Created: 20121018 Date Completed: 20140124 Latest Revision: 20211021 Update Code: 20231215 PubMed Central ID: PMC3548968

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Internet-based dyspnea self-management support for patients with chronic obstructive pulmonary disease.