4.6. Self-treatment
The study intervention is based on a self-management
course used successfully in the COPE-II project, but for the first time modified to address complicated comorbidities. The expertise regarding the development of the action plan for comorbidities has been provided by disease-experts in cardiovascular disease, diabetes, and anxiety and depression.
The diaries and action plans have been developed and refined prior to the start of this trial. A pilot study to evaluate the feasibility and usability was performed in six complex patients with COPD and at least one comorbidity. Compliance and completeness of diary data were as high as in previous studies using comparable diaries. Patients completed a total of 483 diary days (94.5%). Eight symptom-based exacerbations were reported. During seven of these exacerbations, the patients acted according to the action plan. No concerning issues were reported and patients scored the readability of the action plans 9.2 (SD 1.75) and had a high confidence in completing the diary: 9.2 (SD 1.75) (0 = very poor–10 = excellent). Patients who participated in the pilot study will not be included as participants in this trial.