Respiratory Epidemiology and Clinical Research Unit, Montreal Chest Institute of the Royal Victoria Hospital, MUHC, 3650 St.Urbain, Room K1.32, Montreal, QC H2X 2P4, Canada.
Expert Rev Pharmacoecon Outcomes Res. 2004 Feb;4(1):71-7. doi: 10.1586/14737167.4.1.71.
New research and evidence-based self-management programs are now emerging in chronic obstructive pulmonary disease. Patients with moderate-to-severe chronic obstructive pulmonary disease who receive a self-management education with supervision and support of a case manager, have better outcomes than patients receiving standard care. The benefits are on patients' health status and healthcare utilization with markedly decreased hospitalizations, emergency department and unscheduled physician visits. These benefits are worth considering since self-management could also be cost saving. There is no reason to question the value of self-management in chronic obstructive pulmonary disease, especially for those patients who have a decreased health-related quality of life and high exacerbation rate. Self-management should be an integral part of the long-term care of chronic obstructive pulmonary disease patients. Rather than telling the patient to learn to live with their disease, they should be taught to self-manage.
新的研究和基于证据的自我管理计划现在正在慢性阻塞性肺疾病中出现。接受自我管理教育并接受病例管理员监督和支持的中重度慢性阻塞性肺疾病患者,其治疗效果要好于接受标准护理的患者。这些益处体现在患者的健康状况和医疗保健利用上,表现为住院、急诊和非计划性就诊次数明显减少。鉴于自我管理也可能节省成本,因此值得考虑这些益处。没有理由质疑自我管理在慢性阻塞性肺疾病中的价值,尤其是对于那些生活质量下降和加重率高的患者。自我管理应该是慢性阻塞性肺疾病患者长期护理的一个组成部分。我们不应该告诉患者要学会与疾病共存,而应该教导他们进行自我管理。