Frequent counselling of patients including selfmanagement
education also forms an integral part of
COPD management. A recent multi-centric randomised
clinical trial35 has provided evidence that a multicomponent,
skill oriented self management programme–
including an exacerbation action plan – reduced
hospitalisations, emergency visits and improved
HRQoL. These claims, however, were not substantiated
in another comparable randomised study.36 The
beneficial effects of PR, i.e., symptom relief, improved
physical endurance and enhanced HRQoL start
declining towards baseline after 6-12 months of the PR
programme.37 Strategies to maintain the benefits of PR
are yet not clear and more research in this area is needed.
The management problems are population specific and
the results of investigations carried out in other countries
should not be extrapolated to Indian population in toto.
Further research is needed to precisely define the role of
PR programmes in AECOPD in India.