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.

Citation

(2016). Self-management of health care behaviors for COPD: a systematic review and meta-analysis. International Journal of Chronic Obstructive Pulmonary Disease, 305 -326. https://doi.org/10.2147/COPD.S90812

• Acceptance Date: Feb 17, 2016
• Publication Date: Feb 17, 2016
• Journal: International Journal of Chronic Obstructive Pulmonary Disease
• Print ISSN: 1178-2005
• Publisher: Taylor and Francis Group
• Pages: 305 -326
• DOI: https://doi.org/10.2147/COPD.S90812
• Keywords: COPD, self-management, systematic review, meta-analysis
• Publisher URL: http://dx.doi.org/10.2147/COPD.S90812