Given the dearth of COPD self-management interventions that specifically acknowledge multi-morbidity in primary care, we aimed to activate COPD patients through personalised self-management support that recognised the implications of co-morbidities. This single-group experimental study included patients aged 40-84 with a spirometry diagnosis of COPD and at least one co-morbidity. A self-management education programme for COPD in the context of multi-morbidity, based on the Health Belief Model, was tailored and delivered to participants by general practice nurses in face-to-face sessions. At 6 months' follow-up, there was significant improvement in patient activation (p < 0.001), COPD-related quality of life (p = 0.012), COPD knowledge (p < 0.001) and inhaler device technique (p = 0.001), with no significant change in perception of multi-morbidity (p = 0.822) or COPD-related multi-morbidity (0.084). The programme improved patients' self-efficacy for their COPD as well as overall health behaviour. The findings form an empirical basis for further testing the programme in a large-scale randomised controlled trial.

中文翻译：

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通过量身定制的自我管理支持激活患有多种疾病的初级保健COPD患者。

鉴于缺乏专门承认初级保健中多发病的COPD自我管理干预措施，我们旨在通过个性化的自我管理支持来激活COPD患者，该支持认识到合并症的影响。这项单组实验研究包括年龄在40-84岁，肺活量测定诊断为COPD且至少有一种合并症的患者。根据健康信念模型，针对多种疾病的COPD自我管理教育计划是由全科护士在面对面会议中量身定制并提供给参与者的。在6个月的随访中，患者的活动性（p <0.001），COPD相关的生活质量（p = 0.012），COPD知识（p <0.001）和吸入器技术（p = 0.001）有了显着改善，而对多发病（p = 0.822）或与COPD相关的多发病（0.084）的感知没有显着变化。该计划提高了患者对COPD的自我效能以及整体健康行为。这些发现为进一步在大规模随机对照试验中对该程序进行测试提供了经验基础。