Self-management in chronic lung disease: what is missing?

Self-management, as a strategy to support those living with chronic respiratory conditions such as asthma and
COPD, has been widely advocated in guidelines and adopted in practice. However, there can be a disconnect
between the goals of patients and healthcare professionals. Goals and barriers to self-management are often
compounded by the complex social, emotional and medical needs of patients. People living with chronic
respiratory conditions also often have symptoms of anxiety and depression, which can impact on selfmanagement. Self-management therefore requires patients and healthcare professionals to work together and it
is essential to involve patients when designing, implementing and evaluating self-management interventions.
Patient preferences are clearly important and goal setting needs an individual, flexible and responsive
approach from healthcare professionals, which aligns to a more personalised approach to management of
treatable traits and the burden of disease. To achieve these goals, healthcare professionals need education
to support patients in self-management and behaviour change. This approach should lead to shared
decision-making and partnership working that puts the patient right at the centre of their care.