1 National Heart and Lung Institute, Imperial College London, London, UK.
2 Wandsworth Community Healthcare, Central London Community Healthcare NHS Trust, Battersea Studios, London, UK.
Chron Respir Dis. 2019 Jan-Dec;16:1479973119838283. doi: 10.1177/1479973119838283.
Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality. Pulmonary rehabilitation (PR) is offered to patients with functional breathlessness. However, access to PR is limited. The objective of this study was to evaluate whether a 4-week education and exercise programme offered to COPD patients with Medical Research Council (MRC) dyspnoea 1-2 improves disease self-management. Patients were recruited by their GP to attend four weekly 2-h sessions provided by a multidisciplinary team. Patients completed outcome measures before and after the program. Forty-two patients entered the programme and 26 out of 42 (61.9%) completed all sessions. The Bristol COPD Knowledge Questionnaire and Patient Activation Measure improved (both p ≤ 0.001). Disease burden was not reduced according to the COPD assessment test. All patients accepted a referral for ongoing exercise. Fourteen current smokers (81.3%) accepted a referral for smoking cessation, three patients with anxiety or depression (37.5%) accepted a psychological therapies referral. The programme improved COPD disease knowledge, patient activation and stimulated referrals to further services supporting disease management. Randomised controlled trials are warranted for similar interventions for COPD patients with early stage disease.
慢性阻塞性肺疾病（COPD）是发病率和死亡率的主要原因。肺康复（PR）提供给有功能性呼吸困难的患者。然而，获得 PR 的机会有限。本研究的目的是评估为 MRC 呼吸困难 1-2 级的 COPD 患者提供的为期 4 周的教育和运动计划是否可以改善疾病自我管理。患者通过他们的全科医生被招募参加由多学科团队提供的每周 4 次 2 小时的课程。患者在计划前后完成了结果测量。42 名患者参加了该计划，其中 42 名中的 26 名（61.9%）完成了所有课程。布里斯托尔 COPD 知识问卷和患者激活量表有所改善（均 p≤0.001）。根据 COPD 评估测试，疾病负担没有减轻。所有患者都接受了继续锻炼的转介。14 名目前吸烟的患者（81.3%）接受了戒烟转介，3 名患有焦虑或抑郁的患者（37.5%）接受了心理治疗转介。该计划提高了 COPD 疾病知识、患者激活程度，并促进了对进一步支持疾病管理的服务的转介。对于患有早期疾病的 COPD 患者，类似的干预措施需要进行随机对照试验。
