Development and feasibility of a self-management intervention for chronic obstructive pulmonary disease delivered with motivational interviewing strategies

Roberto Benzo, Kristin Vickers, Denise Ernst, Sharon Tucker, Charlene McEvoy, Kate Lorig

Research output: Contribution to journalArticle

40 Scopus citations

Abstract

BACKGROUND: Self-management is proposed as the standard of care in chronic obstructive pulmonary disease (COPD), but details of the process and training required to deliver effective self-management are not widely available. In addition, recent data suggest that patient engagement and motivation are critical ingredients for effective self-management. This article carefully describes a self-management intervention using motivational interviewing skills, aimed to increase engagement and commitment in severe COPD patients. METHODS: The intervention was developed and pilot tested for fidelity to protocol, for patient and interventionist feedback (qualitative) and effect on quality of life. Engagement between patient and interventionists was measured by the Working Alliance Inventory. The intervention was refined on the basis of the results of the pilot study and delivered in the active arm of a prospective randomized study. RESULTS: The pilot study suggested improvements in quality of life, fidelity to theory, and patient acceptability. The refined self-management intervention was delivered 540 times in the active arm of a randomized study. We observed a retention rate of 86% (patients missing or not available for only 14% the scheduled encounters). CONCLUSIONS: A self-management intervention that includes motivational interviewing as the way if guiding patients into behavior change is feasible in severe COPD and may increase patient engagement and commitment to self-management. This provides a very detailed description of the process for the specifics of training and delivering the intervention, which facilitates replicability in other settings and could be translated to cardiac rehabilitation.

Original languageEnglish (US)
Pages (from-to)113-122
Number of pages10
JournalJournal of Cardiopulmonary Rehabilitation and Prevention
Volume33
Issue number2
DOIs
StatePublished - Mar 2013

Keywords

  • COPD
  • behavior change
  • motivational interviewing
  • physical activity
  • self-management

ASJC Scopus subject areas

  • Rehabilitation
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

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