Barriers and facilitators of self-management behaviors among patients with chronic obstructive pulmonary disease and chronic comorbidities: A mixed-methods investigation

Kimberly A. Muellers*, Rachel O'Conor, Andrea M. Russell, Guisselle Wismer, James W. Griffith, Michael S. Wolf, Juan P. Wisnivesky, Alex D. Federman

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objectives: We investigated how individuals with chronic obstructive pulmonary disease (COPD) and multi-morbidity (MM) navigate barriers and facilitators to their health management. Methods: We conducted a mixed-methods study using semi-structured interviews and survey assessments of adults with COPD, hypertension, and/or diabetes. We recruited 18 participants with an average age of 65, with 39% being male, 50% Black, and 22% Hispanic/Latino/a. Five investigators used an iterative, hybrid-coding process combining a priori and emergent codes to analyze transcripts and compare quantitative and qualitative data for themes. Results: Participants reported a generalized approach to their health rather than managing MMs separately. Individuals with good or mixed adherence found daily routines facilitated regular medication use, while those with poor adherence experienced complex prescriptions and life stressors as barriers. Walking was viewed as beneficial but challenging due to limited mobility. Most participants viewed diet as important to their MMs, but only two reported high diet quality and many held inaccurate beliefs about healthy diet choices. Discussion: Participants with MM were highly motivated to engage in self-management activities, but some individuals experienced barriers to maintaining them. Emphasizing an individualized clinical approach to assessing and solving patient barriers may improve self-management outcomes in this complex population.

Original languageEnglish (US)
JournalChronic Illness
DOIs
StateAccepted/In press - 2023

Keywords

  • Multi-morbidity
  • chronic illness
  • chronic obstructive pulmonary disease
  • medication adherence
  • self-management

ASJC Scopus subject areas

  • Health Policy

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