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

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journal contribution
posted on 18.05.2016, 11:10 by K. Jolly, S. Majothi, A. J. Sitch, N. R. Heneghan, R. D. Riley, D. J. Moore, E. J. Bates, A. M. Turner, S. E. Bayliss, M. J . Price, Sally J. Singh, P. Adab, D. A. Fitzmaurice, R. E. Jordan
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, I2 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, I2 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.

Funding

AMT reports grants from University of Birmingham/ National Institute for Health Research (NIHR), during the conduct of the study; REJ was in receipt of an NIHR postdoctoral research fellowship (pdf/01/2008/023) during the conduct of the study; KJ, DAF, REJ, PA, and SJS are investigators on an NIHR SPCR funded trial of self-management for COPD; SJS reports that the University Hospitals of Leicester National Health Service trust holds the IP for a self-management manual for COPD. REJ was funded by NIHR Health Technology Assessment Programme (10/44/01). KJ is part-funded by the National Institute for Health Research (NIHR) Collaborations for Leadership in Applied Health Research and Care (CLAHRC) West Midlands. SJS is part-funded by the CLAHRC-East Midlands. Malcolm Price was supported by funding from a multivariate meta-analysis grant from the MRC Methodology Research Programme (grant reference number: MR/ J013595/1).

History

Citation

International Journal of COPD 2016:11 305–326

Version

VoR (Version of Record)

Published in

International Journal of COPD 2016:11 305–326

Publisher

Dove Medical Press

eissn

1178-2005

Acceptance date

26/08/2015

Available date

18/05/2016

Publisher version

https://www.dovepress.com/self-management-of-health-care-behaviors-for-copd-a-systematic-review--peer-reviewed-article-COPD

Language

en

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