Self-management of health care behaviors for COPD: a systematic review and meta-analysis

Abstract

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.

Journal

Journal ID (nlm-ta): Int J Chron Obstruct Pulmon Dis

Journal ID (iso-abbrev): Int J Chron Obstruct Pulmon Dis

Journal ID (publisher-id): International Journal of COPD

Title: International Journal of Chronic Obstructive Pulmonary Disease

Publisher: Dove Medical Press

ISSN (Print): 1176-9106

ISSN (Electronic): 1178-2005

Publication date Collection: 2016

Publication date (Electronic): 17 February 2016

Volume: 11

Pages: 305-326

Affiliations

[1 ]Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK

[2 ]School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK

[3 ]Research Institute of Primary Care and Health Sciences, Keele University, Keele, Staffordshire

[4 ]Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK

[5 ]Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK

Author notes

Correspondence: Rachel E Jordan, Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK, Tel [phone], Email r.e.jordan@ 123456bham.ac.uk

Article

Publisher ID: copd-11-305

DOI: 10.2147/COPD.S90812

PMC ID: 4762587

PubMed ID: 26937183

Copyright statement: © 2016 Jolly et al. This work is published and licensed by Dove Medical Press Limited

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Categories

Subject: Original Research