Protocol for a randomized trial of self-management support for people with chronic obstructive pulmonary disease...

Successful management of chronic obstructive pulmonary disease (COPD) centers on patient self-management behaviors (SMB) such as controller medication adherence, use of action plans, smoking cessation and more. Individuals with COPD face a number of barriers to effective self-management, including medical comorbidities, cognitive and mental health disorders, and socioeconomic factors. Poor self-management contributes significantly to poor health outcomes in patients with COPD. However, prior research has demonstrated that interventions to improve SMB must be multifaceted and tailored to individual patients' specific barriers to be most effective. This randomized control study will test a 6-month self-management support intervention in 300 adults with Global Initiative for Chronic Obstructive Lung Disease (GOLD) classifications B or E. The intervention is called Supporting self-Management Behaviors in Adults with COPD (SAMBA). It uses health coaches to identify and address barriers to SMB, support home-based pulmonary rehabilitation, and promote use of as-needed antibiotics and oral corticosteroids for early treatment of acute COPD exacerbations. SAMBA will be compared to a time and attention matched control treatment consisting of general COPD education. We hypothesize that patients receiving SAMBA will have better COPD medication adherence, greater exercise capacity, more improved COPD symptoms and quality of life, and fewer hospitalizations and ED visits than control patients. CLINICAL TRIAL REGISTRATION NUMBER: NCT06634810.