Chronic Conditions

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Chronic Obstructive Pulmonary Disease

(Updated  October 18, 2017)

COPD Definition:

Chronic Obstructive Pulmonary Disease (COPD) as a lung disease characterized by chronic obstruction of lung airflow that interferes with normal breathing and is not fully reversible. The more familiar terms 'chronic bronchitis' and 'emphysema' are no longer used, but are now included within the COPD diagnosis. World Health Organization

COPD Guidelines:

COPD clinical guidelines from the University of Michigan Health System

2017 GOLD Pocket Guide to COPD Diagnosis, Management and Prevention

Care Management Interventions

Click Here for an example of a COPD action plan

Diagnosis Specific Concerns

Care Management Intervention

Patient Specific Interventions

Care Manager Resources

Patient Resources

Assessment

Assess patients knowledge level on diagnosis

Preparing for the visit

Comprehensive Assessment Tool

What to Expect at the Physician Appointment

 

Handout - Preparing for the Appointment

Top 5 Questions to Ask the Physician

Diagnosis Education

Provide education regarding COPD diagnosis

  • Causes
  • Risks
  • Symptoms
  • Treatment

Discuss diagnosis with care manager

 

Review educational materials provided

 

Provide teach-back

 

 

COPD Screening Tool for Care Managers

 

Clinical Guidelines and Patient Education from the University of Michigan

 

 

 

 

COPD Handout

 

COPD Care Guide

Shortness of Breath

Help develop COPD action Plan

 

Oxygen therapy

 

Exacerbations: Educate on when to call the physician

Work with care manager to establish personal goals of care

 

When to call your physician:

  • Symptoms persist with medication use
  • Heart rate is fast and/or irregular
  • Lips or fingernails become gray or bluish
  • Unusually hard to walk or talk

COPD Patient Care Plan

 

COPD Action Plan

 

Management of COPD in Primary Care Algorithm from the Department of Veterans Affairs Pocket Card

 

 

Oxygen Therapy - Patient Education

COPD: Learn More Feel Better from National Institute of Health

Positions to Reduce Shortness of Breath

Diaphragmatic Breathing

Medication Management

Provide education on oral medications

 

Provide Teach back regarding inhaler use

 

Provide information on vaccinations

Create medication list of all current medications including OTC and herbal supplements.

 

Demonstrate understanding of medications including:

  • Name and purpose
  • Dosage
  • When to take
  • How to refill

Take medications as prescribed

 

Review educational material

 

Follow up to receive suggested vaccinations

Visual identification of common inhaled medications

 

Information on Pneumococcal Vaccine

 

Anti-inflammatory Medications for COPD

COPD Medication Guidelines from the Cleveland Clinic

Free or Low Cost Medicaitons - MDHHS

Video on how to use your Advair Diskus Inhaler

 

Video on how to use an inhaler with a spacer

 

Educational Sheets for Various Inhalers

 

 

 

 

Action Plan

Educate patient on when to call primary care physician

Provide patient with HF action plan

 

Demonstrate understanding of COPD action plan and when to call physician’s office versus go to Emergency Room

COPD Action Plan

 

COPD Action Plan

Smoking

Provide education on smoking cessation

 

Review materials provided on smoking cessation

Enroll in a smoking cessation program

Smoking Cessation in Michigan

Smoke Free.gov

Nutrition

Educate on diet recommended by physician

Provide education on diet and tools for maintaining diet

  • Good vs bad food
  • Reading food labels

Refer patient to a dietitian or nutritionist

Create diet plan

Demonstrate understanding of prescribed diet

  • Tips- Rest just before eating.
  • Eat more food early in the morning if you're usually too tired to eat later in the day.
  • Avoid foods that cause gas or bloating. They tend to make breathing more difficult.
  • Eat 4 to 6 small meals a day. This enables your diaphragm to move freely and lets your lungs fill with air and empty out more easily
  • If drinking liquids with meals makes you feel too full to eat, limit liquids with meals; drink an hour after meals.

Nutrition Tips for Someone with COPD

Nutrition for Better Breathing

Nutrition from the American Lung Association

Eat Right.org

Activity

Provide education on exercise and COPD if recommended by physician

Create action plan

Provide examples of different types of exercise

Educate patient on signs and symptoms of when to stop exercising

Check with provider prior to starting an exercise regimen

Understand warning signs and when to stop exercising

Follow recommended treatment plan

  • Tips- Start slowly
  • Exercise at the same time each day so it becomes a regular part of the day

Physical Activity and COPD

COPD Excerise and Activity Guidelines

Rated Perceived Exertion Level - RPE

Managing Stress

Educate patient on healthy ways to manage stress

Refer patient to a behavioral health specialist

Demonstrate understanding of healthy ways to manage stress

How to Lower Your Stress

 

Breathing Problems: How to Control Stress

 

Managing Stress - American Lung Association

Common Labs and Tests

Instruct patient on peak-flow

Pulmonary function test

Review test information

Complete tests as ordered by physician

Common Tests for COPD

 

ABG Education for Patients

For a printable version of the care manager interventions Click Here

This chart is not meant to be an inclusive list of interventions or resources for care management but a starting point in working with patients with COPD. Always check with your practice regarding the use of guidelines, resources and education.

Pathophysiology

Article

The ABC's of Pathophysiology

Provides basic pathophysiology for the care manager

Website

Diseases and Conditions - COPD

Includes information on causes, symptom management, treatment and as well as coping and support from the Mayo Clinic

Toolkits

This section provides information on various toolkits to assist with the care management of COPD patients.

Tools

COPD Toolkit

A toolkit from the Breathe New Hampshire initiative. Includes various resources including, action plans, COPD management guide, as well as assessment.

Care Management Learning Resources

This section is for care managers who would like to get additional more specific information relating to asthma.

Guides and Policies

University of Michigan COPD Guidelines

Contains detailed clinical guidelines for the management of COPD

Tools

Case Management Adherence Guide (CMAG)

Guide for care managers working with patients with COPD from the Case Management Society of America

Tools

COPD Guidelines - WHO

Global Initiative for Chronic Obstructive Pulmonary Disease (GOLD). Global Strategy for the Diagnosis, Management, and prevention of Chronic Obstructive Pulmonary Disease created through the World Health Organization provides information on the management, treatment and prevention of COPD.

 

Website

Michigan Department of Health and Human Services

Provides information related to primary care and chronic disease.

Tools

Disease Management - COPD

Provided by the Center for Continuing Education from the Cleveland Clinic takes a look at COPD and provides an overview of the disease including treatment.

Article

Anxiety, Depression and COPD

Strategies to Improve Anxiety and Depression in Patients with COPD: A Mental Health Perspective from the journal of Neuropsychiatric Disease and Treatment

Article

COPD and Nutrition

Undernutrition in Patients with COPD and its Treatments. An article from the journal Nutrients, 2013

Webinars and Presentations