Education and Self-Management

Publisher Summary This chapter is concerned with patient education and self-management and reviews the evidence in favor of those interventions and highlight similarities and differences between self-management education in asthma and chronic obstructive pulmonary disease (COPD). The term patient education has an unpleasant inference suggesting some inadequacy on the patient's behalf, which needs rectifying. It seems preferable to make the concept more positive and to list the constituent parts. For the health care professional an essential prerequisite to patient education is an understanding of how the patients feels about their long-term condition and its management and provide them with optimal care. Personalized self-management advice, which helps them to adjust their lifestyle or treatment to keep well, is necessary. Such advice needs to be produced in a suitable format to ensure it is usable by those with varying literacy skills. The wealth of evidence in favor of self-management education, regular follow up, and the use of written action plans has not unfortunately led to widespread implementation. The reasons why doctors are not implementing a core part of self-management education, which is of proven benefit, are not clear, but probably revolve around a perceived lack of time, lack of suitable templates, and possibly a lack of understanding as to what is involved in this process and what needs to be written down for patients. Current evidence is that self-management education is of significant value in those with asthma but more marginal value in COPD, where it may only be beneficial if combined with other interventions such as pulmonary rehabilitation and case management.