**4.1 Self-management education**

Education in self-management is a crucial and essential component of PR. It stimulates active engagement in healthcare and supports self-efficacy. It has been demonstrated that self-management education is very helpful in enhancing health and lowering healthcare utilization. It is typically given in a one-on-one or small group environment [8]. Individual educational needs are identified during an initial assessment and reviewed throughout the PR program [5, 8]. Key parts of self-management education include discussions of advance directives and counseling on the early identification and treatment of COPD exacerbations [9].