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Meta-Analysis
. 2016 Feb 17:11:305-26.
doi: 10.2147/COPD.S90812. eCollection 2016.

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

Kate Jolly  1 , Saimma Majothi  1 , Alice J Sitch  1 , Nicola R Heneghan  2 , Richard D Riley  3 , David J Moore  1 , Elizabeth J Bates  1 , Alice M Turner  4 , Susan E Bayliss  1 , Malcolm J Price  1 , Sally J Singh  5 , Peymane Adab  1 , David A Fitzmaurice  1 , Rachel E Jordan  1
Affiliations
Meta-Analysis

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

Kate Jolly et al. Int J Chron Obstruct Pulmon Dis. .

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.

Keywords: COPD; meta-analysis; self-management; systematic review.

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Figures

Figure 1
Figure 1
Flow diagram summarizing the study selection process. Abbreviaiton: RCT, randomized controlled trial.
Figure 2
Figure 2
HRQoL (SGRQ) outcomes for multicomponent self-management intervention versus usual care. Notes: ^Indicates that several papers are represented by this lead publication. A = nurse-assisted collaborative management vs UC. B = nurse-assisted medical management vs UC. Abbreviations: ANCOVA, analysis of covariance; CI, confidence interval; HRQoL, health-related quality of life; Int, intervention group; Cont, control group; SGRQ, St George’s respiratory questionnaire; UC, usual care.
See this image and copyright information in PMC

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