Bourbeau 2003.

Study characteristics
Methods	Design: RCT Follow‐up: 12 and 24 months Control group: usual care
Participants	Recruitment: hospital (outpatient) Assessed for eligibility: not reported Randomly assigned: SM: 96; UC: 95 Completed: SM: 86; UC: 79 Mean age: SM: 69.4 (SD 6.5) years; UC: 69.6 (SD 7.4) years Gender (% male): SM: 52; UC: 59 COPD diagnosis: FEV₁ after the use of a bronchodilator between 25% and 70% of the predicted normal value and FEV₁/FVC ratio less than 70% Inclusion of participants in the acute phase: no Major inclusion criteria: hospitalised at least once in the preceding year for an exacerbation; stable COPD (respiratory symptoms and medication unchanged for at least 4 weeks before enrolment); at least 50 years of age; current or previous smoker (at least 10 pack‐years); FEV₁ after the use of a bronchodilator between 25% and 70% of the predicted normal value 14 and FEV₁/FVC ratio < 70%; no previous diagnosis of asthma, left congestive heart failure, terminal disease, dementia, or uncontrolled psychiatric illness; no participation in a respiratory rehabilitation programme in the past year; and no long‐term‐care facility stays Major exclusion criteria: participants with asthma as a primary diagnosis and those with major comorbidities (documented left ventricular failure and any terminal disease), dementia or uncontrolled psychiatric illness
Interventions	Mode: individual sessions at the participant's home, "Living well with COPD" programme with patient workbook, telephone calls Duration: seven face‐to‐face individual sessions of one hour each, scheduled in seven to eight consecutive weeks, 18 telephone calls (weekly calls for the eight weeks' educational period; after eight weeks, monthly phone calls for 12 months) Professional: experienced health professionals (nurses, respiratory therapists, a physiotherapist) who acted as case managers with the supervision and collaboration of the treating physician Assignment of case managers: "The programme was supervised by experienced and trained health professionals..." (Bourbeau 2006, p. 586) “Half‐day training sessions were dedicated to interactive lecturing sessions on each aspect of COPD given by different members of the multidisciplinary team. The rest of the training days included workshops oriented toward how to assess patient needs and the acquisition of motivational and teaching skills using group discussion, demonstration and practice of techniques, case scenarios, and role modeling" (Bourbeau 2006, p. 1705). The case‐manager was accessible to participants during the complete follow‐up period. Self‐management components: self‐recognition of COPD exacerbations, use of a COPD exacerbation action plan, home‐based exercise or physical activity component (optional), diet, COPD medication intake (i.e. adherence, inhalation technique), coping with breathlessness, leisure activities and travelling, energy conservation during day‐by‐day activities, relaxation exercises, adopting a healthy lifestyle, long‐term oxygen (optional) Self‐management topics: smoking cessation, exercise Behavioural change techniques: 7 clusters: goals and planning, feedback and monitoring, shaping knowledge, comparison of behaviour, associations, repetition and substitution, antecedents
Outcomes	1. Hospital admissions 2. Scheduled and unscheduled physician visits 3. Emergency department visits 4. Health‐related quality of life (SGRQ) 5. Pulmonary function 6. Functional exercise capacity 7. COPD exacerbations, based on symptoms
Notes	Completed first year of follow‐up: N = 165 (based on hospital registry database) Completed second year of follow‐up: N = 175 (based on provincial health insurance and hospitalisation database records) Source of funding: this study was funded by an unrestricted grant from Boehringer Ingelheim Canada, Burlington, Ontario, in partnership with the Fonds de la Recherche en Santé du Québec (FRSQ), Montreal, Quebec. Conflict of interest: none declared