Conclusions
Despite the above limitations, we believe that our results
have significance for public health. The health management program significantly increased awareness and knowledge among patients and practitioners, improved management within the limitations of access to pharmacotherapy,
and reduced the rates of HADS and smoking,
indirectly manifesting the changes in the BODE index.
These finding support the idea that our health management program may serve as an effective intervention strategy for managing patients with COPD who reside in rural areas. Given the irregularity of treating patients with COPD in rural areas of China, use of the health management approach would be an inexpensive and practical means of increasing awareness and knowledge among patients and
practitioners, improving management within the limitations of access to pharmacotherapy, and reducing psychological disorders and smoking, indirectly preventing deterioration and decreasing deaths from COPD.