Efraimsson 2008.

Methods	Design: RCT Follow‐up: 3 to 5 months Control group: usual care
Participants	Recruitment: nurse‐led primary healthcare clinic. Assessed for eligibility: 110. Randomly assigned: SM: 26, UC: 26. Completed: SM: 26, UC: 26. Mean age: SM: 66 (SD 9.4) years; UC: 67 (SD 10.4) years. Gender (% male): SM: 50.0, UC: 50.0. COPD diagnosis: mild, moderate, severe or very severe COPD based on spirometry, lung capacity after bronchodilator use, based on GOLD criteria. Inclusion of participants in the acute phase: not reported. Major inclusion criteria: diagnosed with mild, moderate, severe or very severe COPD based on spirometry, lung capacity after bronchodilator use, based on GOLD criteria. Major exclusion criteria: diagnosed severe mental disorders such as schizophrenia, dementia or alcohol or drug abuse.
Interventions	Mode: individual sessions at the outpatient and nurse‐led primary healthcare clinic Duration: two face‐to‐face individual sessions for self‐care education during 3‐5 months for one hour each by the nurse Professional: COPD nurse, physician, if needed: dietician, medical social worker, physical therapist, occupational therapist Training of case managers: not reported Self‐management components: action plan COPD exacerbations, iterative process with feedback on actions, self‐recognition of COPD exacerbations, education regarding COPD, smoking cessation, exercise or physical activity component Self‐management topics: smoking cessation, exercise, diet, (maintenance) medication, correct device use, coping with breathlessness/breathing techniques, other: instructions on the coughing technique to prevent infections and exacerbations, measurement on oxygen saturation before and after exertion, psycho‐social counselling and support, counselling on infection prevention Exercise programme: yes (optional), dialogue on physical activity and exercise. When needed, a dietician, a medical social worker, a physical therapist and an occupational therapist were consulted. Smoking cessation programme: yes (optional), motivational dialogue on smoking cessation based on Prochaska and DiClementes’ transtheoretical model of the stages of change. The model is based on open questions to help participants reflect on their smoking habits and empower patients to quit smoking. Behavioural change techniques: ten clusters: goals and planning, feedback and monitoring, social support, shaping knowledge, natural consequences, comparison of behaviour, associations, repetition and substitution, comparison of outcomes, reward and threat, regulation, antecedents, identity, scheduled consequences, self‐belief, covert learning. Action plan components: self‐recognition of exacerbations, self‐treatment of exacerbations, contact healthcare providers for support
Outcomes	1. health‐related quality of life (SGRQ) 2. smoking 3. COPD knowledge
Notes	Included in previous review update; more information regarding intervention components and iterative process needed