Health outcomes of self- and family management programs among community-dwelling older people with chronic obstructive pulmonary disease: a randomized controlled trial

Abstract Background Chronic obstructive pulmonary disease (COPD) significantly affects the quality of life of older adults. The growing impact of this chronic condition poses significant challenges for healthcare systems worldwide. This study evaluated an 8-week technology-enhanced self-and family management program targeting health outcomes, including self-management behaviors, exercise tolerance assessed by the 6-Minute Walk Test (6MWT), dyspnea severity, depression, and family functioning as reported by family members. Methods This randomized controlled trial included 86 older adults with COPD. Participants were matched by age, sex, and disease severity, and then randomly assigned to either the experimental group (n = 43) or the control group (n = 43) using a simple randomization procedure based on a lottery method. The experimental group received the self- and family management program supported by the LINE application in addition to standard care, while the control group received standard care alone. Outcomes were assessed using validated instruments at baseline, Week 4, and Week 8. Results Within the intervention group, significant improvements over time were observed in self-management behaviors, exercise tolerance, dyspnea severity, and family functioning (all p < .001). Depression levels did not change significantly within either group, as baseline scores were within the normal range. Between groups, the intervention group demonstrated significantly greater improvements than the control group in exercise tolerance (6MWT: Week 4: MD = 56.29 m, p = .003; Week 8: MD = 99.07 m, 95% CI [62.59, 135.55], p < .001), dyspnea severity (Week 4: MD = − 15.24, p < .001; Week 8: MD = − 29.29, 95% CI [− 32.11, − 26.47], p < .001), and family functioning (Week 4: MD = − 9.69, p < .001; Week 8: MD = − 11.69, 95% CI [− 13.61, − 9.77], p < .001). Between-group differences in self-management behaviors and depression were not statistically significant at any time point. Conclusions The technology-enhanced self-and family management program demonstrated significant effectiveness in improving health outcomes among older adults with COPD in community settings. This evidence-based nursing intervention, which integrates mobile technology and family support, provides a practical framework for nurses to enhance patient care and achieve positive health outcomes while also improving family functioning. Trial registration This study was registered in the Thai Clinical Trials Registry (TCTR) with registration number TCTR20240903003, registered on 03/09/2024 (retrospectively registered). URL: https://www.thaiclinicaltrials.org/TCTR20240903003 .