Self-treatment of exacerbations with action plans reduces exacerbation duration, hospitalisations, and health care costs in non-complex patients with COPD. The most recent Cochrane review regarding COPD self-management emphasized that self-treatment of exacerbations is an important component of COPD self-management. Effects might result from a quicker start of appropriate treatment via self-initiation of
corticosteroids and/or antibiotics. However, action plans are not always suitable and have a potential to be unsafe for patients with multi-morbidities. Comorbid symptoms can overlap symptoms of COPD and therefore limit the applicability, effectiveness and safety of symptom-based COPD self treatment
guidelines. The use of symptom-based COPD action
plans can lead to initiation of incorrect actions and/or delay of proper treatment for the comorbidities. Moreover, data on the impact of self-management and action plans are conflicting. Literature shows that the effectiveness of action plans is limited if not incorporated in more extensive, individualised,
self-management training programs. Self-management training intends to change behaviour and instils the confidence to recognise exacerbations and self-manage exacerbations. Also, ongoing case manager support is recognized as an additional component to achieve effective and safe self-management.