1. BARRIERS TO CARE AND NEEDS OF PATIENTS WITH COPD Bart Thoonen MD,PhD Radboud University Nijmegen Dept of General Practice On behalf of WONCA

2. Who is in charge of your COPD? Caregivers are not the only ones responsible for treating your COPD. It is most important for you as a patiënt to learn how to slow down the progression of COPD yourself and how to deal with your COPD.

3. Needs of patients?

4. COPD is disabling disease From ‘Confronting COPD’

5. www.astmafonds.nl

6. The role of health professionals Green Lanier D, Dovey SMLA, Fryer GE Jr, Yawn BP, The ecology of medical care revisited. N Engl J Med. 2001 Jun 28;344(26):2021-5.

7. Who’s in charge of your COPD? Patient Physician Self management Shared responsabilities

8. Self management - definition Patients explicitly make informed decisions on how to deal with COPD Physician should challenge patient To become more independant To explore own possibilities and limitations To take control

9. Self management – what is needed outcomesbehaviourSelf efficacy Skills Knowledge Earlier experience Practice Feedback Earlier experience Practice Feedback Proper actions Integration in daily life Proper actions Integration in daily life Improve QOL Reduce complications Improve QOL Reduce complications Self- management

10. Knowledge and skills Patients need to know and accept they have COPD Ability to monitor disease Ability to take proper action

11. The role of primary care Early diagnosis Continuity of care outcomesbehaviourSelf efficacy Skills Knowledge Earlier experience Practice Feedback Earlier experience Practice Feedback Proper actions Integration in daily life Proper actions Integration in daily life Improve QOL Reduce complications Improve QOL Reduce complications Self-management

12. Who is in charge of your COPD?