Patients' use of mHealth for self-management of knee osteoarthritis: results of a 6-week pilot study (Preprint)

2021 ◽  
Author(s):  
Brittany Shewchuk ◽  
Lee A Green ◽  
Tanya Barber ◽  
Jean Miller ◽  
Sylvia Teare ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Knee Osteoarthritis ◽  
Patient Activation ◽  
Qualitative Assessment ◽  
Self Management ◽  
Care Providers ◽  
Knee Oa ◽  
System Usability Scale

BACKGROUND In previous work, a prototype mobile health (mHealth) App was co-designed with patients, family physicians, and researchers to enhance self-management and optimize conservative management for patients with mild to moderate knee osteoarthritis (OA). OBJECTIVE To evaluate the overall usability, quality, and effectiveness of an mHealth App prototype for aiding knee OA self-management from the perspectives of OA patients and health care providers (HCPs). METHODS Using methods triangulation of qualitative and quantitative data, we conducted a pilot evaluation of an mHealth App prototype co-developed with patients and HCPs. We recruited adult patients aged >20 years with early knee OA (n=18) who experienced knee pain on most days of the month at any time in the past and HCPs (n=7) to participate. In the qualitative assessment, patient and HCPs perspectives were elicited on the likeability and usefulness of App features and functionalities, and the perceived impact of the App on patient-HCP communication. The quantitative assessment involved evaluating the App using usability, quality, and effectiveness metrics. The patient baseline assessments included a semi-structured interview and survey to gather demographics, and to assess quality of life (EQ5D-5L) and patient activation (PAM). Following the 6-week usability trial period, a follow-up survey assessed patients’ perceptions of App usability and quality, and longitudinal changes in quality of life and patient activation. Semi-structured interviews and surveys were also conducted with HCPs (n=7) at baseline to evaluate usability and quality of the App prototype. RESULTS Interviews with patients and HCPs revealed overall positive impressions of the App prototype features and functionalities relating to likeability and usefulness. Between the baseline and follow-up patient assessments, mean EQ5D-5L scores improved from 0.77 to 0.67 (p=0.04) and PAM scores increased from 80.4 to 87.9 (p=0.01). Following the 6-week evaluation, patients reported a mean system usability scale (SUS) score of 57.8 indicating marginal acceptability according to SUS cut-offs. The mean number of goals set over the usability period 2.47 (SD 3.08) and mean number of activities completed for knee OA self-management over the study period were 22.2 (SD 17.8). Spearman’s rank correlation (rs) calculations revealed follow-up PAM scores were weakly correlated (rs = -0.32) with the number of goals achieved and the number (rs=0.19) of activities performed over the 6-week usability period. HCPs reported a mean SUS score of 39.1, indicating unacceptable usability. CONCLUSIONS This evidence-based and patient-centered App prototype represents a potential use of mHealth for improving outcomes and enhancing conservative care by promoting patient activation and shared decision-making around OA management. However, the future iterations of the App prototype are required to address shortcomings in usability and quality.

scholarly journals Factors associated with access to health services and quality of life in knee osteoarthritis patients: a multilevel cross-sectional study

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Siriwan Choojaturo ◽  
Siriorn Sindhu ◽  
Ketsarin Utriyaprasit ◽  
Chukiat Viwatwongkasem
Keyword(s):  
Quality Of Life ◽  
Health Service ◽  
Health Services ◽  
Self Management ◽  
Access To Health Services ◽  
Patient Factors ◽  
Cross Sectional ◽  
Knee Oa ◽  
Access To Health

Abstract Background The main purpose of health service systems is to improve patients’ quality of life (QoL) and to ensure equitable access to health services. However, in reality, nearly half of knee osteoarthritis (OA) patients present to the health system do not have access to health services, and their QoL remains poor. These circumstances raise important questions about what (if any) factors can improve health care accessibility and QoL for knee OA patients. Methods A multicenter, cross-sectional survey was performed with 618 knee OA patients who received care at 16 hospitals in Thailand. Structural equation modeling (SEM) was conducted to investigate the association of health service factors and patient factors with access to health services and QoL. Results The QoL of knee OA patients was very poor (mean score = 33.8). Only 2.1% of the knee OA patients found it easy to obtain medical care when needed. Approximately 39.4% of them were able to access appropriate interventions before being referred for knee replacement. More than 85% of orthopedic health services had implemented chronic disease management (CDM) policy into practice. However, the implementation was basic, with an average score of 5.9. SEM showed that QoL was determined by both health system factors (β = .10, p = .01) and patient factors (β = .29, p = .00 for self-management and β = −.49, p = .00 for disease factors). Access to health services was determined by self-management (β = .10, p = .01), but it was not significantly associated with QoL (β = .00, p = 1.0). Conclusions This study provides compelling information about self-management, access to health services and QoL from the individual and health service system perspectives. Furthermore, it identifies a need to develop health services that are better attuned to the patient’s background, such as socioeconomic status, disease severity, and self-management skills.

scholarly journals Self-management interventions for people with severe mental illness: systematic review and meta-analysis

2019 ◽  
Vol 214 (5) ◽  
pp. 260-268 ◽  
Author(s):  
Melanie Lean ◽  
Miriam Fornells-Ambrojo ◽  
Alyssa Milton ◽  
Brynmor Lloyd-Evans ◽  
Bronwyn Harrison-Stewart ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Systematic Review ◽  
Mental Illness ◽  
Severe Mental Illness ◽  
Meta Analysis ◽  
Health Problems ◽  
Self Management ◽  
Management Interventions

BackgroundSelf-management is intended to empower individuals in their recovery by providing the skills and confidence they need to take active steps in recognising and managing their own health problems. Evidence supports such interventions in a range of long-term physical health conditions, but a recent systematic synthesis is not available for people with severe mental health problems.AimsTo evaluate the effectiveness of self-management interventions for adults with severe mental illness (SMI).MethodA systematic review of randomised controlled trials was conducted. A meta-analysis of symptomatic, relapse, recovery, functioning and quality of life outcomes was conducted, using RevMan.ResultsA total of 37 trials were included with 5790 participants. From the meta-analysis, self-management interventions conferred benefits in terms of reducing symptoms and length of admission, and improving functioning and quality of life both at the end of treatment and at follow-up. Overall the effect size was small to medium. The evidence for self-management interventions on readmissions was mixed. However, self-management did have a significant effect compared with control on subjective measures of recovery such as hope and empowerment at follow-up, and self-rated recovery and self-efficacy at both time points.ConclusionThere is evidence that the provision of self-management interventions alongside standard care improves outcomes for people with SMI. Self-management interventions should form part of the standard package of care provided to people with SMI and should be prioritised in guidelines: research on best methods of implementing such interventions in routine practice is needed.Declaration of interestsNone.

scholarly journals P1547THE EFFECT OF INTERNET-BASED CLOSED-LOOP MANAGEMENT ON QUALITY OF LIFE IN PATIENTS ON PERITONEAL DIALYSIS, A SELF-CONTROL STUDY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Fang Cao
Keyword(s):  
Quality Of Life ◽  
Peritoneal Dialysis ◽  
Management System ◽  
Closed Loop ◽  
Health Management ◽  
Management Model ◽  
Self Management ◽  
Dialysis Patients

Abstract Background and Aims With the continuous advancement of information technology, mobile Internet has entered every family and shown its unique advantages. The development of hospital's information construction on the management of chronic disease, the continuous improvement of hospital APP and Wechat public number functions have provided intelligent services for patients throughout the process. Along with this process, the way of hospital patient follow-up has gradually expanded and improved, and the automation and intellectualization of follow-up work has become a reality. However, The establishment of peritoneal dialysis health management professional team and the implementation of closed-loop health management model, which is based on the Internet closed-loop management model has no clear impact on the self-management ability, quality of life and treatment effect of peritoneal dialysis patients. To explore the effectiveness of Internet based in-hospital and out of hospital closed loop management on the quality of life of patients with peritoneal dialysis, it is necessary to establish a set of closed loop management system for chronic diseases patients with promotion and practical significance. Method From July 2017 to July 2018, 214 patients with continuous peritoneal dialysis were followed up regularly in the Department of Nephrology of our hospital, and voluntarily participated in this study. The mean follow-up time was 12.6 ± 1.5 months. The differences of blood electrolytes, quality control indexes, self-management ability, quality of life of renal disease and hospital satisfaction were observed before and after closed-loop management. Results Ability of self-management behavior (p < 0.001), quality of life (p < 0.001), satisfaction (p < 0.001), the incidence of infection (p < 0.05), serum albumin (p < 0.05), hemoglobin (p < 0.05)were improved after participating in the closed-loop management. Conclusion The closed-loop management system based on Internet closed-loop management model is effective for the quality of life and treatment effect of peritoneal dialysis patients, which integrates the core functions of follow-up records, intelligent early warning, doctor-patient communication and health education. Through this closed-loop management, medical staff can digitally collect, store, transmit and process the information of in-hospital and out-of-hospital conditions through follow-up analysis, health guidance and remote assistance to achieve the purpose of patient health management. This study shows that this closed-loop management system can effectively manage the health of peritoneal dialysis patients, and provides a replicable model for the management of chronic diseases. Therefore, a comprehensive closed-loop management system based on mobile Internet and information technology, with clinical care as the leading factor and peritoneal dialysis patients as the terminal is a feasible and acceptable follow-up management method for peritoneal dialysis patients and hospitals.

A co-produced self-management programme improves psychosocial outcomes for people living with depression

2015 ◽  
Vol 20 (4) ◽  
pp. 242-255 ◽  
Author(s):  
Andy Turner ◽  
Alba X. Realpe ◽  
Louise M. Wallace ◽  
Joanna Kosmala-Anderson
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Health Status ◽  
Management Programme ◽  
Self Management ◽  
Depression Symptoms ◽  
Management Skills ◽  
Content Type

Purpose – There is growing interest in self-management support for people living with mental health problems. The purpose of this paper is to describe the evaluation of a co-designed and co-delivered self-management programme (SMP) for people living with depression delivered as part of large scale National Health Service quality improvement programme, which was grounded in the principles of co-production. The authors investigated whether participants became more activated, were less psychologically distressed enjoyed better health status, and quality of life, and improved their self-management skills after attending the seven-week SMP. Design/methodology/approach – The authors conducted a longitudinal study of 114 people living with depression who attended the SMP. Participants completed self-reported measures before attending the SMP and at six months follow up. Findings – Patient activation significantly improved six months after the SMP (baseline M=49.6, SD=12.3, follow up M=57.2, SD=15.0, t(113)=4.83, p < 0.001; d=0.61). Participants’ experience of depression symptoms as measured by the Patient Health Questionnaire-9 significantly reduced (baseline M=15.5, SD=6.8, follow up M=10.6, SD=6.9, t(106)=7.22, p < 0.001, d=−0.72). Participants’ anxiety and depression as measured by the Hospital Anxiety Depression Scale also decreased significantly (baseline anxiety: M=13.1, SD=4.2, follow up M=10.2, SD=4.4, t(79)=6.29, p < 0.001, d=−0.69); (baseline depression: M=10.3, SD=4.6, follow up M=7.7, SD=4.5, t(79)=5.32, p < 0.001, d=−0.56). The authors also observed significant improvement in participants’ health status (baseline M=0.5, SD=0.3, follow up M=0.6, SD=0.3, t(97)=−3.86, p < 0.001, d=0.33), and health-related quality of life (baseline M=45.4, SD=20.5, follow up M=60.8, SD=22.8, t(91)=−2.71, p=0.008, d=0.75). About 35 per cent of participant showed substantial improvements of self-management skills. Originality/value – The co-produced depression SMP is innovative in a UK mental health setting. Improvements in activation, depression, anxiety, quality of life and self-management skills suggest that the SMP could make a useful contribution to the recovery services in mental health.

scholarly journals Effects of variable frequencies of kinesthesia, balance and agility exercise program in adults with knee osteoarthritis: study protocol for a randomized controlled trial

2020 ◽  
Author(s):  
Aysha I. Adhama ◽  
Mukadas O. Akindele ◽  
Aminu A. Ibrahim
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Knee Osteoarthritis ◽  
Conventional Therapy ◽  
Controlled Trial ◽  
Hip Osteoarthritis ◽  
Life Questionnaire ◽  
Knee Oa ◽  
Randomized Controlled

Abstract Background: Knee osteoarthritis (OA) is a common painful and disabling condition that affects older individuals. Proprioceptive training programs in the form of kinesthesia, balance and agility (KBA) exercises have been reported to be beneficial for individuals with knee OA. However, the most optimal treatment dosage of KBA exercise is still unclear. The aim of this study is to determine the effects of different frequencies of KBA treatment (i.e. twice-weekly or thrice-weekly) in adults with knee OA.Methods: A single (assessor) blind, three-arm parallel, multi-center randomized controlled trial will be conducted. Eighty-four adults with knee OA will be recruited from four tertiary hospitals in Northwestern Nigeria and randomly assigned into one of three intervention groups; twice-weekly KBA (n = 28), thrice-weekly KBA (n = 28), and conventional physiotherapy or control (n = 28) in the ratio of 1:1:1. Participants in the conventional therapy group will receive two sessions of brief patient education, and 16 sessions of ultrasound therapy, stretching and strengthening exercises for 8 weeks. Participants in the two different KBA groups will receive KBA exercise according to the designed sessions for 8 weeks in addition to the conventional therapy. All groups will be assessed pre-intervention, immediately post-intervention and at 8 weeks, 3-month, 4-month, and 6-month post-randomization. The primary outcome will be physical function (Ibadan Knee and Hip Osteoarthritis Outcome Measure) while the secondary outcomes will be pain (Visual Analogue Scale for pain), knee stability (Knee Outcome Survey-Activities of Daily Living Scale), proprioception (electronic goniometer), and quality of life (Osteoarthritis Knee and Hip Quality of Life Questionnaire).Discussion: Findings of this study may provide evidence on the effectiveness of KBA exercise and the ideal number of sessions needed to achieve the highest effectiveness in adults with knee OA.Trial registration: Pan African Clinical Trials Registry, (PACTR201810713260138), Retrospectively registered on 28 November 2017.

scholarly journals Effect of Nucart VG (Boswellia serrata in combination with veg glucosamine sulphate) in comparison with glucosamine sulphate to improve quality of life of knee osteoarthritis patients: a randomized controlled trial

2021 ◽  
Vol 7 (5) ◽  
pp. 976
Author(s):  
Vijay G. Goni ◽  
Mukesh Mishra ◽  
Sailee Kadam ◽  
Sharat S. Gandhi
Keyword(s):  
Quality Of Life ◽  
Health Status ◽  
Knee Osteoarthritis ◽  
Controlled Trial ◽  
Open Label ◽  
Boswellia Serrata ◽  
Group Randomized Trial ◽  
Glucosamine Sulphate

<p class="abstract"><strong>Background:</strong> <em>Boswellia serrata</em> has been proved to be an effective and safe herb for the treatment of osteoarthritis (OA). This study aims at assessing the synergistic effect of this herb with vegetarian glucosamine sulphate, a nutritional supplement, on knee osteoarthritis using quality of life indicators.</p><p class="abstract"><strong>Methods:</strong> This<strong> </strong>was an open label, parallel group randomized trial of 12-week duration. Sixty-six subjects were equally randomized to two treatment arms: <em>Boswellia serrata</em> extract (600 mg) and glucosamine (750 mg) [Nucart VG]; and glucosamine sulphate (market comparator) 750 mg. Patients were administered 1 tablet twice-a-day post-meal for three months. Efficacy of treatment was measured on primary end-points like EuroQol-5D (EQ-5D) (health status indicator), visual analogue scale (VAS) and Western Ontario and McMaster Universities osteoarthritis index (WOMAC) scale (pain indicators), while safety was measured in terms of vital parameters. Both intention-to-treat (ITT) and per-protocol (PP) analyses were performed for comparing scores between the two groups.<strong></strong></p><p class="abstract"><strong>Results:</strong> The baseline characteristics of patients between two groups were insignificantly different (p&gt;0.05). In ITT analysis, the health status (EQ-5D score) of patients in Nucart VG group improved significantly than the comparator group at follow up 2 (p=0.037) and showed further improvement at follow up 3 (p=0.012). The pain indicators i.e. VAS and WOMAC scores were significantly lower in Nucart VG group right from follow up 1 till follow up 3 (p&lt;0.05). Similar were the observations during PP analysis.</p><p class="abstract"><strong>Conclusions:</strong> Nucart VG is beneficial for the treatment of mild to moderate knee OA, as inferred from the functional and health status assessment.</p>

scholarly journals An Assessment of Cancer Pain Control in an LMIC Oncology Clinic

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 230s-230s
Author(s):  
A. Joseph ◽  
O. Salako ◽  
A. Alabi ◽  
A. Adenipekun
Keyword(s):  
Quality Of Life ◽  
Cancer Pain ◽  
Pain Assessment ◽  
Pain Control ◽  
Assessment Tool ◽  
Study Group ◽  
Care Providers ◽  
Prevalence Of Pain

Background: Cancer has become a leading cause of morbidity and mortality in adults globally. Pain is universally one of the most commonly encountered symptoms by health and supportive care providers involved in care of cancer patients. Inadequate pain control negatively impacts the patient´s quality of life, and may slow down the healing process. Health care providers often ignore pain control as a target of treatment as they focus on reducing the tumor burden. Pain management should be considered an important target and end point in the treatment of cancer patients. Aim: To assess the prevalence of pain, oncologists´ prescribing patterns; and efficacy of pain control in the Radiotherapy Department of the Lagos University Teaching Hospital. Methods: Adult cancer outpatients were assessed using a Universal Pain Assessment Tool and followed up for 2-6 weeks thereafter. Pain scores were assessed at first interview and at the follow-up appointment within 2 weeks minimum and 6 weeks maximum. Results: 347 adult clinic attendees were recruited, assessed, and followed up with interviewer-administered questionnaires over a close-out period of 6 weeks. There was an 85% (298 respondents) prevalence of pain in the study group; with over half of respondents characterizing their pain in the moderate to severe ranges. [Figure: see text] 9 out of 10 respondents stated the cancer was the primary source of their pain. Other sources of pain were medical tests; and treatment-related such as chemotherapy and radiation therapy. 86 patients (29% of study group) were not asked about pain by their attending physician, and all respondents stated their physician had not used any pain assessment tool to determine the nature or severity of their pain. [Figure: see text] Oral nonsteroidal analgesics were the most frequently prescribed form of pain control (237 patients), with radiotherapy coming in second (69 patients). The only available strong opioid analgesics at the oncology pharmacy were oral morphine and parenteral pentazocine. Oxycodone, fentanyl pethidine, and hydromorphone were unavailable. Interventional (e.g., cordotomy) and alternative (e.g., massage) forms of pain control were not prescribed in any patients. 43 respondents (15%) despite being in pain, did not receive any form of treatment or recommendation for pain control. At follow-up appointment 2-6 weeks after; 4 out of 10 respondents had not obtained pain relief from instituted measures. [Figure: see text] Conclusion: Undertreatment of cancer pain remains a major concern. The treatment process must begin with a proper and thorough evaluation of the patient's pain; a clear pain control goal and end point target; and regular reevaluation with application of guidelines when adequate control is not achieved. Inclusion of pain assessment and management guidelines in medical training would be of benefit to reduce the prevalence of inadequately controlled pain in patients living with cancer; ultimately improving their quality of life.

scholarly journals Intra-Articular Hybrid Hyaluronic Acid Injection Treatment in Overweight Patients with Knee Osteoarthritis: A Single-Center, Open-Label, Prospective Study

2021 ◽  
Vol 11 (18) ◽  
pp. 8711
Author(s):  
Dalila Scaturro ◽  
Fabio Vitagliani ◽  
Pietro Terrana ◽  
Daniele Cuntrera ◽  
Vincenzo Falco ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Hyaluronic Acid ◽  
Knee Osteoarthritis ◽  
Disease Severity ◽  
Prospective Trial ◽  
Open Label ◽  
Knee Oa ◽  
Symptomatic Knee ◽  
Significant Difference

Background: A BMI > 25 is the most decisive, albeit modifiable, risk factor for knee osteoarthritis (KOA). This study aimed at assessing the efficacy of intra-articular injections of hybrid hyaluronic acid (HA) complexes (Sinovial® H-L) for the treatment of KOA in overweight patients in terms of disease severity, cardiocirculatory capacity, and quality of life. Materials: In this single-site, open-label, prospective trial, 37 patients with symptomatic knee OA were assessed at baseline and 3 months after ultrasound-guided intra-articular injection of hybrid HA complexes (Sinovial® H-L). Results: Primary variables displaying a statistically significant improvement after treatment were pain (VAS), disease severity (WOMAC), and cardiopulmonary capacity (6 min walk test). Among secondary variables, quality of life (SF-12) improved significantly, as did analgesic intake for pain control. No statistically significant difference was observed in body fat and muscle mass percentage measured by bioelectrical impedance analysis. Conclusions: Intra-articular hybrid HA injections are significantly effective in improving OA-related disease severity, cardiopulmonary function, and analgesic intake. This supports the role of hybrid HA viscosupplementation as a nonpharmacological treatment to relieve pain, reduce disability, improve quality of life, and limit the risk of polypharmacy in overweight patients with knee OA.

The Effectiveness of Intra-Articular Injection of Hypertonic Saline in Pain Control and Function of Patients with Knee Osteoarthritis

2020 ◽  
Author(s):  
Behrouz Tavana ◽  
Sirous Azizi ◽  
Sharif Najafi ◽  
Ensie Taftian ◽  
Nastaran Maghbouli
Keyword(s):  
Quality Of Life ◽  
Knee Osteoarthritis ◽  
Hypertonic Saline ◽  
Pain Reduction ◽  
Functional Improvement ◽  
Obese Patients ◽  
Knee Oa ◽  
Vas Score ◽  
American College Of Rheumatology

Background: The aim of this study was to report the effectiveness of intra-articular injection of hypertonic saline in pain reduction and functional improvement in patients with knee osteoarthritis (OA). Methods: Patients with knee pain and dysfunction who fulfilled the American College of Rheumatology criteria and whose illness was sub-acute or chronic were enrolled. We performed a single intra-articular injection of 5 cc of hypertonic (5%) saline solution. Measured outcomes were Visual Analogue Scale (VAS) score and Knee Injury and Osteoarthritis Outcome Score (KOOS) evaluated before and 1 month after intervention. Results: A total of 28 patients with mean age of 66.3 years were surveyed. Overall, study participants reported clinically and statistically significant reduction in VAS and KOOS subscales for symptoms, pain, function, daily living, sports, recreational activities, and quality of life in one month of follow-up with respect to the patients’ mean baseline scores (by 24.47%, 42.74%, 54.96%, 43.78%, and 63.63%, respectively). Although obese patients [body mass index (BMI) ≥ 30 kg/m2] showed less improvement in terms of pain, sports, and quality of life subscales of KOOS, compared with non-obese patients (BMI < 30 kg/m2); VAS score difference was not significant. Conclusion: Intra-articular injection of hypertonic saline yields a statistically and clinically significant short-term pain reduction and functional improvement of patients with knee OA.

Chronic Obstructive Pulmonary Disease Discharge Education and Quality of Life Evaluation: A Feasibility Study

2018 ◽  
Vol 32 (3) ◽  
pp. 328-348 ◽  
Author(s):  
Patricia Conley ◽  
Teresa J. Kelechi ◽  
Lynne S. Nemeth ◽  
Martina Mueller
Keyword(s):  
Quality Of Life ◽  
Chronic Obstructive Pulmonary Disease ◽  
Action Plan ◽  
Phone Call ◽  
Self Management ◽  
Chronic Obstructive ◽  
Secondary Diagnosis ◽  
Obstructive Pulmonary Disease

Background and Purpose:Discharge instructions provided to hospitalized participants with chronic obstructive pulmonary disease (COPD) are essential to promote improved health outcomes, reduce incidence of hospitalization, and enhance quality of life (QOL). This study evaluated the feasibility of implementing the American Lung Association’s COPD Action Plan and assessment of QOL among participants hospitalized for acute exacerbation of COPD or COPD as a primary or secondary diagnosis.Methods:The study was conducted on a cohort of critically ill participants hospitalized on a progressive care unit. The Principal Investigator administered the WHOQOL-BREF Questionnaire to assess QOL before discharge and 30 days after discharge via phone call. Reach, Effectiveness, Adoption, Implementation, and Maintenance was used to evaluate outcomes from the discharge study.Results:Among participants enrolled (n = 50), 13 completed the in-hospital and follow-up phone call. Participants scored (12; 92% answered “yes”) that they learned appropriate COPD self-management skills, such as change in respiratory symptoms and appropriate actions to take. At 30-day follow-up: number of rehospitalizations (12; 99%), no emergency department visits, and (1; 1%) emergency department visit for insulin reaction, not COPD. Most frequent principal admitted diagnosis was acute respiratory failure, and secondary diagnosis was COPD. There was no significant difference in QOL comparing scores at discharge to 30-day follow-up, using the Wilcoxon signed-rank test.Implications for Practice:COPD education can increase participant satisfaction in receiving self-management instructions from an action plan near the time of discharge based on a small sample.

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