Self management COPD benefits only the motivated

In this large community based trial of patients post-COPD exacerbation, they were randomized to usual care, or intensive self management  for a year. At the end of a year, overall the self management program was not associated with lower rates of readmissions or deaths, but in the subgroup of patients that were “successful” in the home management program (42% of the intervention group), they had half the risk of readmissions/death compared to those “unsuccessful”. The results are encouraging that those compliant with self management can significantly reduce the risk of readmissions / death, but determining in advance who will be motivated to adhere is difficult (abstract)