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Written action plans ‘reduce COPD exacerbations’

By Lilian Anekwe

COPD patients who are given written action plans by their GP recover more quickly from exacerbations, according to Canadian research.

A year-long prospective cohort study, conducted as part of a larger randomised controlled trial, recorded data on exacerbations for 252 patients with COPD who received a written action plan for prompt treatment of exacerbations, with instructions from the GP to initiate standing prescriptions for both antibiotics and prednisone within three days of the onset of an exacerbation.

Patients who adhered to their action plan and followed the instructions it had set – this occurred in 40% of cases – adherence reduced exacerbation recovery time by 5.8 days. Written plans also reduced unscheduled healthcare utilisation, but only by 6%, a difference which did not reach statistical significance.

Patients who were vaccinated against influenza, had a cardiac comorbidity, were younger or who had a lower FEV1 as percentage predicted were more likely to adhere to action plans.

Dr Jean Bourbeau, director of the respiratory epidemiology and clinical research unit at the Montreal Chest Institute, concluded: ‘This study shows that adherence to a written action plan is associated with a reduction in exacerbation recovery time by prompt treatment.

‘Knowing the factors that are associated with proper and prompt utilisation of an action plan permits healthcare professionals to better focus their self-management support on appropriate patients.’

Thorax, online 30 October

Written action plans ‘reduce COPD exacerbations’