Journal
INTERNATIONAL JOURNAL OF CHRONIC OBSTRUCTIVE PULMONARY DISEASE
Volume 11, Issue -, Pages 305-+Publisher
DOVE MEDICAL PRESS LTD
DOI: 10.2147/COPD.S90812
Keywords
COPD; self-management; systematic review; meta-analysis
Categories
Funding
- University of Birmingham/National Institute for Health Research (NIHR)
- NIHR [pdf/01/2008/023]
- NIHR SPCR
- NIHR Health Technology Assessment Programme [10/44/01]
- National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care (CLAHRC) West Midlands
- CLAHRC-East Midlands
- MRC Methodology Research Programme [MR/J013595/1]
- Medical Research Council [MR/J013595/1] Funding Source: researchfish
- National Institute for Health Research [PDF/01/023, CL-2012-09-006, 10/44/01] Funding Source: researchfish
- MRC [MR/J013595/1] Funding Source: UKRI
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Purpose: This systematic review aimed to identify the most effective components of interventions to facilitate self-management of health care behaviors for patients with COPD. PROSPERO registration number CRD42011001588. Methods: We used standard review methods with a systematic search to May 2012 for randomized controlled trials of self-management interventions reporting hospital admissions or health-related quality of life (HRQoL). Mean differences (MD), hazard ratios, and 95% confidence intervals (CIs) were calculated and pooled using random-effects meta-analyses. Effects among different subgroups of interventions were explored including single/multiple components and multicomponent interventions with/without exercise. Results: One hundred and seventy-three randomized controlled trials were identified. Self-management interventions had a minimal effect on hospital admission rates. Multicomponent interventions improved HRQoL (studies with follow-up >6 months St George's Respiratory Questionnaire (MD 2.40, 95% CI 0.75-4.04, I-2 57.9). Exercise was an effective individual component (St George's Respiratory Questionnaire at 3 months MD 4.87, 95% CI 3.96-5.79, I-2 0%). Conclusion: While many self-management interventions increased HRQoL, little effect was seen on hospital admissions. More trials should report admissions and follow-up participants beyond the end of the intervention.
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