5. Discussion
COPD is a complex systemic disease involving more than airflow obstruction, and it often coexists with other chronic diseases that can influence patients' health status and prognosis. We have developed a novel symptom-based COPD self-treatment approach using action plans, which incorporates management of frequently existing comorbidities (cardiovascular
diseases, diabetes, and anxiety and depression) that may confuse the use of COPD action plans or are known to be triggered by COPD exacerbations. A clinical trial is necessary to evaluate the effects of these individualised self-treatment action plans.