FIG. 24:  This Figure shows the effectiveness of self management in COPD.^[20]  Self- management is considered one of the two major components of pulmonary rehabilitation, and this retrospective review shows the effect of self-management interventions on hospitalization and utilization in patients with COPD.  This is self management of all interventions, not specifically pulmonary rehabilitation, but the aggregate of these seven studies shows a substantial reduction in hospitalization with collaborative self management, with an overall odds ratio of 0.60, suggesting a substantial beneficial effect on healthcare utilization.