The effects of a six week Stanford Model chronic disease self management program, a six week pulmonary rehabilitation program with/without weekly maintenance in chronic obstructive pulmonary disease

INTERVENTION: Subjects are randomised to the six‐week self‐management program Stanford Model Chronic Disease Self‐Management Program (CDSMP). The CDSMP is a licensed program conducted under licence from Arthritis Victoria by a registered nurse with either a clinician or peer leader, both of whom are accredited with Arthritis Victoria as program facilitators. The six week program comprises a two an a half hour per week group attendance and covers formation of action plans, relaxation therapy, medication usage, effective communication with the health care team, nomination of a power of attorney, end of life decision making, encouragement of candidate to participate in activity (eg walking) and symptom management. The program is facilitated in a manner to foster participant self efficacy with weekly feedback from the program facilitators. For the duration of the intervention each participant wears a pedometer. CONDITION: Chronic obstructive pulmonary disease PRIMARY OUTCOME: Anxiety Depressions Dyspnea Exercise Tolerance Health Care Usage: Hospital admissions & length of stay, emergency department presentations, ambulatory care use, community resource & medication usage Health Related Quality of Life Self‐Efficacy SECONDARY OUTCOME: None. INCLUSION CRITERIA: Diagnosis of COPD, Candidates who report activity limited by dyspnea,Clinically stable for a minimum of 4 weeks prior to trial entry, Literate in English,Intact cognitive function.