Self-management programs are being developed and applied with more patients diagnosed as having COPD. For example, Lomunda and Steinsbekk described the outcome of a one-year self-management program (SMG) and a two year pulmonary rehabilitation program (PRG). Two open prospective observational studies were conducted with 30 patients in each study. The SMG lasted 46 hours over 12 months; the PRG had, in addition, three weekly exercise sessions. In the SMG, health-related quality of life (HRQL) showed an improvement one year after the end of the intervention, but there was no change in the six minutes walking test. The PRG had an improvement in HRQL and the walking test at the end of intervention. None of the groups showed any clinical relevant change in lung function.

WHAT THE STUDY MAY MEAN TO READER. The participants in the SMG showed an improvement in quality of life and no deterioration in exercise tolerance one year after the end of the program. Participants in the PRG significantly improved their quality of life and exercise tolerance the first year, but had no further clinical relevant improvement the second year. These findings may lead investigators to decide whether adding an exercise component is worthwhile in designing self-management programs for COPD. The investigators in this study should be commended for gathering follow-up data for two years.

BK Lomunda, A Steinsbekk. Observational studies of a one-year self-management program and a two-year pulmonary rehabilitation program in patients with COPD. International Journal of Chronic Obstructive Pulmonary Disease, 2007;2:617-624.