Effects of an internet based tool for self-management in patients with COPD–a controlled pragmatic pilot trial

Self-management is an important part of COPD management and have demonstrated positive outcomes including reduced health care use. However, access to pulmonary rehabilitation including self-management is limited for a large part of the COPD-population. The aim of this study was to evaluate the effects of an internet based tool, the COPD-web, to promote self-management in patients with COPD. The trial was conducted at six primary care units in Sweden. The intervention group (n=43) had access to the COPD-web during a 3-month period while the control group (n=40) received usual care. Before and after the intervention period, both groups answered questionnaires with regard to symptoms, dyspnea, physical activity, health literacy, conceptual knowledge and self-efficacy to perform physical activity. At 3-months, the patients who have had access to the COPD-web reported an increased level of physical activity, increased time spent in physical activity and increased time spent performing exercise training in comparison to the control group. The intervention group had also increased self-efficacy to perform physical activity as well as increased knowledge on how to 1) be physically active, 2) perform exercise training, 3) use breathing techniques at rest and 4) use techniques for mucus-mobilization in comparison to the control group. No differences were observed between groups with regard to symptoms, dyspnea and health literacy. Use of an internet based tool might be an effective alternative strategy to promote self-management in patients with COPD, increasing conceptual knowledge, level of physical activity as well as time spent performing exercise training.