International Journal of COPD (May 2024)
Factors Associated with Patient Education in Patients with Chronic Obstructive Pulmonary Disease (COPD) – A Primary Health Care Register-Based Study
Abstract
Annika Lindh,1,2 Maaike Giezeman,2,3 Kersti Theander,2 Ann-Britt Zakrisson,4 Elisabeth Westerdahl,4 Caroline Stridsman5 1School of Health Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; 2Centre for Clinical Research and Education, Region Värmland, Karlstad, Sweden; 3School of Medical Sciences, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; 4University Health Care Research Center, Faculty of Medicine and Health, Örebro University, Örebro, Sweden; 5Department of Public Health and Clinical Medicine, The OLIN Unit, Umeå University, Umeå, SwedenCorrespondence: Caroline Stridsman, Department of Public Health and Clinical Medicine, The OLIN unit, Umeå University, Robertsviksgatan 9, Luleå, S-971 89, Sweden, Tel +46-920 28 44 82, Email [email protected]: Patient education in chronic obstructive pulmonary disease (COPD) is recommended in treatment strategy documents, since it can improve the ability to cope with the disease. Our aim was to identify the extent of and factors associated with patient education in patients with COPD in a primary health care setting.Patients and Methods: In this nationwide study, we identified 29,692 COPD patients with a registration in the Swedish National Airway Register (SNAR) in 2019. Data on patient education and other clinical variables of interest were collected from SNAR. The database was linked to additional national registers to obtain data about pharmacological treatment, exacerbations and educational level.Results: Patient education had been received by 44% of COPD patients, 72% of whom had received education on pharmacological treatment including inhalation technique. A higher proportion of patients who had received education were offered smoking cessation support, had performed spirometry and answered the COPD Assessment Test (CAT), compared with patients without patient education. In the adjusted analysis, GOLD grade 2 (OR 1.29, 95% CI 1.18– 1.42), grade 3 (OR 1.41, 95% CI 1.27– 1.57) and grade 4 (OR 1.79, 95% CI 1.48– 2.15), as well as GOLD group E (OR 1.17, 95% CI 1.06– 1.29), ex-smoking (OR 1.70, 95% CI 1.56– 1.84) and current smoking (OR 1.45, 95% CI 1.33– 1.58) were positively associated with having received patient education, while cardiovascular disease (OR 0.92, 95% CI 0.87– 0.98) and diabetes (OR 0.93, 95% CI 0.87– 1.00) were negatively associated with receipt of patient education.Conclusion: Fewer than half of the patients had received patient education, and the education had mostly been given to those with more severe COPD, ex- and current smokers and patients with fewer comorbidities. Our study highlights the need to enhance patient education at an earlier stage of the disease.Keywords: chronic obstructive pulmonary disease, inhaler use, patient education, primary health care, register study
