An economic evaluation of a self-management programme of activity, coping and education for patients with chronic obstructive pulmonary disease

Chron Respir Dis. 2016 Feb;13(1):48-56. doi: 10.1177/1479972315619578. Epub 2015 Dec 23.


The aim was to undertake a cost-utility analysis of a self-management programme of activity, coping and education (SPACE) for chronic obstructive pulmonary disease (COPD). The analysis was conducted alongside a six-month randomized controlled trial in 30 primary care settings. The economic analysis used data from 184 patients with confirmed diagnosis of COPD, forced expiratory volume in one second/forced vital capacity ratio <0.7 and with grade 2-5 on the Medical Research Council dyspnoea scale. Participants received either a self-management programme consisting of an education manual (SPACE for COPD) and consultation or usual care. Six-month costs were estimated from the National Health Service and Personal Social Services perspective and quality-adjusted life years (QALYs) were calculated based on patient responses at baseline and six months.The mean difference in costs between usual care and SPACE FOR COPD programme was -£27.18 (95% confidence interval (CI); -£122.59 to £68.25) while mean difference in QALYs was -0.10 (95% CI; -0.17 to -0.02). The results suggest that the intervention is more costly and more effective than usual care. The probability of the intervention being cost-effective was 97% at a threshold of £20,000/QALY gained. We conclude that the SPACE FOR COPD programme is cost-effective compared to usual care.

Keywords: COPD; RCT; cost-effectiveness analysis; cost-utility analysis; education; self-management.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological*
  • Cost-Benefit Analysis
  • Forced Expiratory Volume
  • Humans
  • Patient Education as Topic*
  • Pulmonary Disease, Chronic Obstructive / economics
  • Pulmonary Disease, Chronic Obstructive / therapy*
  • Self Care / economics*

Associated data

  • ISRCTN/ISRCTN35501175