BARRIERS FACED BY CHRONIC OBSTRUCTIVE PULMONARY DISEASE (COPD) PATIENTS IN SELF-MANAGEMENT AT HOME

Main Article Content

Ghulam Sabri
Parveen Akhtar
Kainat Asmat

Keywords

Barriers, COPD, Self-care management, self-management, Pakistan

Abstract

Objective and Methods: This cross-sectional study assessed the self-management barriers faced by Chronic Obstructive Pulmonary Disease (COPD) patients. Adult patients (≥ 18 years) diagnosed with COPD for at least six months and engaged in self-care at home were included in this study. Data was collected through in-person interviews using a structured questionnaire and analyzed using descriptive statistics.


Results: Response rate was 98% (371/377). Age of the participants ranged from 41-73 years, with a mean of 53.3 (SD ± 9.65) years. Majority participants were men (82%), married (96.7%), laborers (65.5%) and residents of rural areas (90.6%). Above two-third (79%) were current or previous smokers. Main barriers reported by the participants included lack of knowledge about disease and self-management at home. Additional barriers reported were lack of training in exercise, breathing and relaxation techniques, non-affordability of cost of medications and home-base-oxygen therapy, absence of community support and difficulties in accessing and communicating with healthcare providers.


Conclusion: This study highlighted multi-faceted barriers faced by COPD patients, emphasizing the necessity for comprehensive, patient-centered interventions tailored to the specific needs and circumstances of these individuals.

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References

1. Hogg JC. Pathophysiology of airflow limitation in chronic obstructive pulmonary disease. The Lancet. 2004 Aug 21;364(9435):709-21.
2. Barnes PJ. Mechanisms in COPD: differences from asthma. Chest. 2000 Feb 1;117(2):10S-4S.
3. Agusti AG, Noguera A, Sauleda J, Sala E, Pons J, Busquets X. Systemic effects of chronic obstructive pulmonary disease. European Respiratory Journal. 2003 Feb 1;21(2):347-60.
4. Yang K, Wu Y, Chen D, Liu S, Chen R. The impact of lung function on extra-pulmonary diseases and all-cause mortality in US adult population with and without COPD. Clinical Epidemiology. 2020 Sep 25:997-1005.
5. Prasad B. Chronic obstructive pulmonary disease (COPD). International Journal of Pharmacy Research & Technology. 2020 Jul 1;10(1):67-71.
6. Worldometer CC. Worldometer. 2021. CrossRef][Google Scholar]. 2021:1-22.
7. Masjedi M, Ainy E, Zayeri F, Paydar R. Assessing the prevalence and incidence of asthma and chronic obstructive pulmonary disease in the Eastern Mediterranean region. Turkish thoracic journal. 2018 Apr;19(2):56.
8. Razzaq S, Nafees AA, Irfan M, Fatmi Z. Prevalence and Risk Factors of COPD in Karachi, Pakistan: Findings from the Adult Asthma Study-Karachi. InISEE Conference Abstracts 2018 Feb 1.
9. Mendis S. Global status report on noncommunicable diseases 2014. World health organization; 2014.
10. GBD 2015 Chronic Respiratory Disease Collaborators. Global, regional, and national deaths, prevalence, disability-adjusted life years, and years lived with disability for chronic obstructive pulmonary disease and asthma, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015. The Lancet. Respiratory Medicine. 2017 Sep;5(9):691.
11. Clari M, Matarese M, Ivziku D, De Marinis MG. Self-care of people with chronic obstructive pulmonary disease: a meta-synthesis. The Patient-Patient-Centered Outcomes Research. 2017 Aug;10:407-27.
12. Effing TW, Bourbeau J, Vercoulen J, Apter AJ, Coultas D, Meek P, Valk PV, Partridge MR, Palen JV. Self-management programmes for COPD: moving forward. Chronic respiratory disease. 2012 Feb;9(1):27-35.
13. Cravo A, Attar D, Freeman D, Holmes S, Ip L, Singh SJ. The importance of self-management in the context of personalized care in COPD. International Journal of Chronic Obstructive Pulmonary Disease. 2022 Jan 22:231-43.
14. Liou HL, Huang YT, Lai ZY, Tsou YY, Tsai YC, Yu HH, Chen MS. Improving self‐care efficacy and quality of life with a self‐management program among patients with chronic obstructive pulmonary disease: A quasi‐experimental study. Nursing & Health Sciences. 2020 Sep;22(3):629-38.
15. Zafar M. Health-Related Quality of Life in Patients with Chronic Obstructive Pulmonary Disease in Karachi Pakistan—A Cross-Sectional Study. MAMC Journal of Medical Sciences. 2020 Jan 1;6(1):17.
16. Gadoury MA, Schwartzman K, Rouleau M, Maltais F, Julien M, Beaupre A, Renzi P, Begin R, Nault D, Bourbeau J. Self-management reduces both short-and long-term hospitalisation in COPD. European Respiratory Journal. 2005 Nov 1;26(5):853-7.
17. Guidelines for the management of chronic obstructive pulmonary disease: National clinical guidelines: Pakistan chest society. 2020
18. Ogunbayo OJ, Russell S, Newham JJ, Heslop-Marshall K, Netts P, Hanratty B, Kaner E. Understanding the factors affecting self-management of COPD from the perspectives of healthcare practitioners: a qualitative study. NPJ primary care respiratory medicine. 2017 Sep 18;27(1):54.
19. Baba MA, Khan SE, Hasnain F, Sakina R, Talat A, Irfan AB. Exploring the treatment types and challenges in patients with chronic obstructive pulmonary disease: a qualitative study. Middle East J Fam Med. 2022 Jan 1;7(10):23.
20. Zeb H, Younas A, Ahmed I, Ali A. Self‐care experiences of Pakistani patients with COPD and the role of family in self‐care: a phenomenological inquiry. Health & Social Care in the Community. 2021 Sep;29(5):e174-83.
21. Khatiwada B, Rajbhandari B, Mistry SK, Parsekar S, Yadav UN. Prevalence of and factors associated with health literacy among people with Noncommunicable diseases (NCDs) in South Asian countries: A systematic review. Clinical Epidemiology and Global Health. 2022 Nov 3:101174.
22. Saleem S, Khalid N, Tahir A, Mahmood H, Saleem S. Clinician's Perspective on the Management of Asthma and Chronic Obstructive Pulmonary Disease (COPD) Care at Primary Health Care Settings in Pakistan. Context Analysis. 2014.
23. Bayliss EA, Steiner JF, Fernald DH, Crane LA, Main DS. Descriptions of barriers to self-care by persons with comorbid chronic diseases. The Annals of Family Medicine. 2003 May 1;1(1):15-21.
24. Sethi JM, Rochester CL. Smoking and chronic obstructive pulmonary disease. Clinics in chest medicine. 2000 Mar 1;21(1):67-86.
25. Bai JW, Chen XX, Liu S, Yu L, Xu JF. Smoking cessation affects the natural history of COPD. International journal of chronic obstructive pulmonary disease. 2017 Nov 16:3323-8.
26. Yang H, Wang H, Du L, Wang Y, Wang X, Zhang R. Disease knowledge and self-management behavior of COPD patients in China. Medicine. 2019 Feb;98(8).
27. Sandelowsky H, Krakau I, Modin S, Ställberg B, Nager A. COPD patients need more information about self-management: a cross-sectional study in Swedish primary care. Scandinavian journal of primary health care. 2019 Oct 2;37(4):459-67.
28. Bringsvor HB, Skaug K, Langeland E, Oftedal BF, Assmus J, Gundersen D, Osborne RH, Bentsen SB. Symptom burden and self-management in persons with chronic obstructive pulmonary disease. International journal of chronic obstructive pulmonary disease. 2018 Jan 24:365-73.
29. Kouijzer M, Brusse-Keizer M, Bode C. COPD-related fatigue: Impact on daily life and treatment opportunities from the patient's perspective. Respiratory medicine. 2018 Aug 1;141:47-51.
30. Sama SR, Kriebel D, Gore RJ, DeVries R, Rosiello R. Environmental triggers of COPD symptoms: a case cross-over study. BMJ Open Respiratory Research. 2017 Aug 1;4(1):e000179.
31. Russell S, Ogunbayo OJ, Newham JJ, Heslop-Marshall K, Netts P, Hanratty B, Beyer F, Kaner E. Qualitative systematic review of barriers and facilitators to self-management of chronic obstructive pulmonary disease: views of patients and healthcare professionals. NPJ primary care respiratory medicine. 2018 Jan 17;28(1):2.
32. O’Toole J, Krishnan M, Riekert K, Eakin MN. Understanding barriers to and strategies for medication adherence in COPD: a qualitative study. BMC pulmonary medicine. 2022 Mar 19;22(1):98.
33. Bauer WS, Schiffman RF. Factors influencing self-management of chronic obstructive pulmonary disease by community-dwelling adults. Western Journal of Nursing Research. 2020 Jun;42(6):423-30.
34. Disler RT, Green A, Luckett T, Newton PJ, Inglis S, Currow DC, Davidson PM. Experience of advanced chronic obstructive pulmonary disease: metasynthesis of qualitative research. Journal of pain and symptom management. 2014 Dec 1;48(6):1182-99.