It should becoming clear to readers that we describe how self-management can be used by patients with a wide variety of chronic conditions. So it is that we discuss how patients with bronchiectasis are using self-management skills to improve their health. Bronchiectasis is a lung disease that results from an infection or other factors that injure the walls of the airways, the tubes that carry air in and out of your lungs. The injury starts a cycle in which the airways slowly lose their ability to clear out mucus. The mucus, in turn, builds up and creates an environment in which bacteria can grow. This leads to repeated serious lung infections with each infection causing more damage to the airways. Over time, the airways become stretched out, flabby, and scarred; they can no longer move air in and out of the lungs. As with most chronic conditions, bronchiectasis cannot be cured, although it can generally be controlled.

The characteristics of bronchiectasis appear to make it ideal for self-management.
A recent study in the U.K. looked at the physical and psychosocial impact of the condition to see, to whether patients with bronchiectasis were receptive to self-management. A second aim was to identify any obstacles or sources of support for a disease-specific self-management program. A total of 32 patients with a diagnosis of bronchiectasis attended four focus groups. Each group was videotaped and analyzed. As expected, bronchiectasis had an impact on the patients' physical and psychosocial well-being. Patients demonstrated they could self-manage their condition with strategies that included self-control of medication and airway clearance. Perceived obstacles to self-management included lack of information and confidence.

Comments. The authors concluded that while patients with bronchiectasis have their lives disrupted, but are willing to learn and perform self-management. This is really only a pilot program, but it does suggest yet another target population for self-management. There is no cure for bronchiectasis, but successful performance of self-management skills could result in a far better quality of life for patients with the condition. This alone is a goal worth pursuing. The broad array of programs developed for asthma and COPD offer a foundation upon which to build an effective program for the self-management of bronchiectasis. This should hasten progress for widespread development and application of self-management programs for the condition.

K. Lavery et al. Self-management in bronchiectasis: the patients' perspective. European Respiratory Journal, 2007;29:541-547.