COPD & Emphysema Support Group
COPD is a progressive disease characterized by airflow obstruction or limitation. Emphysema is characterized by loss of elasticity of the lung tissue, destruction of structures supporting the alveoli and of capillaries feeding the alveoli. Both have symptoms that include shortness of breath, among other respiratory troubles. If you are a COPD or Emphysema sufferer, join...
Study finds substantial risk in self-care of COPD
Nurse.com News
Wednesday May 16, 2012
A self-management program for chronic obstructive pulmonary disease poses risks, according to a study that had to be stopped because of excess mortality among the participants.
In background information for the study, which appears in the May 15 issue of the Annals of Internal Medicine, 23 researchers affiliated with Veterans Affairs hospitals noted that self-monitoring and management of some chronic diseases can improve patient outcomes.
Hospitalizations for exacerbations of COPD are associated with decreases in quality of life, lung function and life expectancy, so the researchers hypothesized that a self-management program could benefit patients.
They enrolled 960 COPD patients in 20 VA hospital-based outpatient clinics in a randomized, controlled trial comparing a comprehensive care management program (CCMP) with guideline-based usual care. All patients had been hospitalized for COPD within the last year.
The CCMP included individual and group education sessions, an action plan for identification and treatment of exacerbations and scheduled telephone calls from a case manager. Patients in both groups were provided with a COPD information booklet, and their physicians received a copy of COPD guidelines and instructions to follow them.
The researchers planned to follow both groups to record the time to first hospitalization. However, a safety monitoring board stopped the trial before enrollment could be completed. Of the 209 patients enrolled in the CCMP group, 28 deaths occurred from all causes versus 10 in the usual care group.
The researchers found no differences in the number of hospitalizations or the time to initiation of treatment for an acute exacerbation of COPD. They could not determine the cause of increased mortality or the reason that CCMP patients did not initiate treatment sooner. They concluded that self-management may not be appropriate for COPD.
To download a PDF of the study, visit http://bit.ly/JsUH79.
http://news.nurse.com/article/20120516/NATIONAL02/105280008/-1/frontpage
I thought some of you might be interested in reading this study, I was..
Easy Breathing to all,
Love
Holly
Nurse.com News
Wednesday May 16, 2012
A self-management program for chronic obstructive pulmonary disease poses risks, according to a study that had to be stopped because of excess mortality among the participants.
In background information for the study, which appears in the May 15 issue of the Annals of Internal Medicine, 23 researchers affiliated with Veterans Affairs hospitals noted that self-monitoring and management of some chronic diseases can improve patient outcomes.
Hospitalizations for exacerbations of COPD are associated with decreases in quality of life, lung function and life expectancy, so the researchers hypothesized that a self-management program could benefit patients.
They enrolled 960 COPD patients in 20 VA hospital-based outpatient clinics in a randomized, controlled trial comparing a comprehensive care management program (CCMP) with guideline-based usual care. All patients had been hospitalized for COPD within the last year.
The CCMP included individual and group education sessions, an action plan for identification and treatment of exacerbations and scheduled telephone calls from a case manager. Patients in both groups were provided with a COPD information booklet, and their physicians received a copy of COPD guidelines and instructions to follow them.
The researchers planned to follow both groups to record the time to first hospitalization. However, a safety monitoring board stopped the trial before enrollment could be completed. Of the 209 patients enrolled in the CCMP group, 28 deaths occurred from all causes versus 10 in the usual care group.
The researchers found no differences in the number of hospitalizations or the time to initiation of treatment for an acute exacerbation of COPD. They could not determine the cause of increased mortality or the reason that CCMP patients did not initiate treatment sooner. They concluded that self-management may not be appropriate for COPD.
To download a PDF of the study, visit http://bit.ly/JsUH79.
http://news.nurse.com/article/20120516/NATIONAL02/105280008/-1/frontpage
I thought some of you might be interested in reading this study, I was..
Easy Breathing to all,
Love
Holly
Also, since it's repeated again and again that it's a progressive deterioration of lung function, there may be a fatalistic attitude...what's the point of running to the ER when it's the natural course of things.
Maybe because I've had the misfortune to have crappy doctors, but I also have yet to have a "feel good" day. So it may feel like there's nothing the ER is going to do for me that I can't do myself here at home. I haven't had an ER visit in six years, but at the time it was oxygen (got it here at home) and nebulizer (got it). Sometimes they use steroids, but I've not found them particularly helpful. So it's easy to see why someone might not bother to go sit in the ER for 4-5 hours for what seems like the same thing we could do at home. And this was the free VA; I would think out in the real world where people have to pay for stuff, most people have to be at death's door before they would spend the thousands for an ER visit.
LOL But I was a little jaded about healthcare, even before I was diagnosed, so the above could reflect that.
I respectfully disagree with some of what you say. Not everything can you do at home that is done in an emergency room. There are times when drugs must be administered intravenously, blood tests and x-rays taken, your heart monitored, and I.V. lines inserted. These are very common when it comes to a severe exacerbation, and sometimes done so the exacerbation doesn't become severe.
Acknowledging we are all different and there are places in this world where medical services are not available nor are the personnel up on the latest with COPD, if there is a hospital or emergency room available and you are having a pretty strong exacerbation and unable to get to your physician, I would strongly recommend not to fool around with it. I did - thought I could do it all by myself and I ended up with 19 days in the hospital and being declared clinically dead at one point.
Please remember, the life you save may be your own.
Best,
Joni
I took exception to .."everything they do in ER is what you can do at home if you really learn about how to cope." Still do.
And, although I certainly feel others can make their own decisions, as said, I feel it advisable if an exacerbation occurs not to attempt to handle it on your own.
Not trying to necessarily prove any point. For me, I didn't have any mind set nor shame - just no one told me beforehand of how serious it could end up. Wish they had. Then, I wouldn't have hesitated going, instead I thought I'd do my "at home" stuff (nebulizer, etc.) and it'd get all better. Wrong. It didn't.
Best....
P.S. I hope no one feels shame nor self-blame about having COPD, Lots of people who didn't smoke get it, just as there are those who smoked like chimneys that will never get it, so please don't be hard on yourself.
were doing for me.
Sadly I have lost faith in a lot of modern medicine because I feel all
they want is our money and weather or not we get better is secondary To keep us dependent on meds and hospitals insures
they keep making the big bucks.
and we think that tomorrow will be better, after all we are taking the medications.
Its important to know when its time to call 911 or head to emergency room for extra help.
I think doctors need to better educate us so we understand clearly when we need to begin taking steroids and antibiotics and when its time to ask for more help.
I like what Joni said about the hospital being able to keep a close eye on blood work, oxygen levels, and heart rate, xrays etc. and can administrator IV when needed for dehydration and for medications and they have the BiPap machine for us if we get too tired to breath, or need extra help that way.
I think its important to recognise the symptoms that say we need more help, and we cant really handle it by our selves.
Keep in close contact with your doctors office when sick is a good thing too.
It always better safe than sorry.
Easy breathing to all,
Love Holly
so I go....although I have been lately thinking how stupid I am...
But this last time they all told me nurse and the doctor that I should go to the ER when not sure....and I did the right thing last weekend...
so it made me feel ok.
They wanted to keep me over night...but I really wanted my bed at home and they couldn't fig out what it is anyway....as usual.
I can't remember last year what it felt like having my Plurscy (mis spell) but I might be having it again...it hurt like it...but I don't remember...like having that baby it hurt but you forget there you go again having another baby....then it all comes back that is my mediford for today...smile.
But I am a poster child of going to the ER when your not sure...when you've done all they tell you to do first...
I even call the nusrse line....so I cross my T's and doted my I's...
That's what anyone can do....
don't be sad be happy you can go to a place for help....it might be something else never know? right?
just my two cents woth is all.
good luck
god bless
I would be lost and probably dead with out our good doctors and hospitals, and researchers.
It is important to have a doctors your can trust and rely on, I think there are far more good doctors than not.
I am sorry that some of you have had problems, and hope you get the help you need with doctors who understand and can treat you as you need to be.
Easy Breathing to all,
Love
Holly