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. 2018 Nov 23;28(1):44.
doi: 10.1038/s41533-018-0111-9.

Systematic review of the effectiveness of community-based self-management interventions among primary care COPD patients

K Jolly  1 , M S Sidhu  2 , E Bates  1 , S Majothi  1 , A Sitch  1 , S Bayliss  1 , H J Samuel Kim  3 , R E Jordan  4
Affiliations

Systematic review of the effectiveness of community-based self-management interventions among primary care COPD patients

K Jolly et al. NPJ Prim Care Respir Med. .

Abstract

COPD self-management reduces hospital admissions and improves health-related quality of life (HRQoL). However, whilst most patients are managed in primary care, the majority of self-management trials have recruited participants with more severe disease from secondary care. We report the findings of a systematic review of the effectiveness of community-based self-management interventions in primary care patients with COPD. We systematically searched eleven electronic databases and identified 12 eligible randomised controlled trials with seven included in meta-analyses for HRQoL, anxiety and depression. We report no difference in HRQoL at final follow-up (St George's Respiratory Questionnaire total score -0.29; 95%CI -2.09, 1.51; I2 0%), nor any difference in anxiety or depression. In conclusion, supported self-management interventions delivered in the community to patients from primary care do not appear to be effective. Further research is recommended to identify effective self-management interventions suitable for primary care populations, particularly those with milder disease.

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Conflict of interest statement

R.E.J. and K.J. were investigators on the PSM COPD trial, which evaluated the effectiveness of a self-management intervention for patients diagnosed with mild COPD (MRC I/II). PSM COPD was funded by the National Institute of Health Research (NIHR) School for Primary Care Research and NIHR CLAHRC West Midlands. The remaining authors declare no competing interests.

Figures

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Fig. 1
Article selection
Fig. 2
Fig. 2
Quality assessment of included studies Percentages represent the percentage of included articles having a high risk of bias (black bar), unclear risk of bias (light grey bar) or low-risk (medium grey bar)
Fig. 3
Fig. 3
Meta-analysis of SGRQ-Total scores *adjusted results used
See this image and copyright information in PMC

References

    1. Britton M. The burden of COPD in the U.K.: results from the confronting COPD survey. Respir. Med. 2003;97(Suppl C):S71–S79. doi: 10.1016/S0954-6111(03)80027-6. - DOI - PubMed
    1. GOLD. From the Global Strategy for the Diagnosis, Management and Prevention of COPD, Global Initiative for Chronic Obstructive Lung Disease (GOLD) 2017. Available at: http://goldcopd.org. 2017.
    1. Zwerink M, et al. Self management for patients with chronic obstructive pulmonary disease. Cochrane Database Syst. Rev. 2014;3:CD002990. - PMC - PubMed
    1. Adab P, et al. Cohort profile: the Birmingham COPD cohort study. Int. J. Epidemiol. 2016;46:23. - PubMed
    1. Haughney J, et al. The distribution of COPD in UK general practice using the new GOLD classification. Eur. Respir. J. 2014;43:993–1002. doi: 10.1183/09031936.00065013. - DOI - PubMed

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