Clinical-Effectiveness of Self-Management Interventions in Chronic Obstructive Pulmonary Disease An Overview of Reviews
Chronic Respiratory Disease
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Self-management (SM) is defined as the provision of interventions to increase patients’ skills and confidence, empowering the individual to take an active part in their disease management. There is uncertainty regarding the optimal format and the short and long term benefits of chronic obstructive pulmonary disease (COPD) SM interventions in adults. Therefore, a high quality overview of reviews was updated to examine their clinical-effectiveness. Sixteen reviews were identified, interventions were broadly classified as education or action plans, complex interventions with a SM focus, pulmonary rehabilitation (PR), telehealth and outreach nursing. Systematic review and meta-analysis quality and the risk of bias of underlying primary studies were assessed. Strong evidence was found that PR is associated with significant improvements in health related quality of life (HRQoL). Limited to moderate evidence for complex interventions (SM focus) with limited evidence for education, action plans, teleheath interventions and outreach nursing for HRQoL was found. There was strong evidence that education is associated with a significant reduction in COPD-related hospital admissions; moderate to strong evidence that telehealth interventions and moderate evidence that complex interventions (SM focus) are associated with reduced health care utilisation. These findings from a large body of evidence suggesting that SM, through education or as a component of PR, confers significant health gains in people with COPD in terms of HRQoL. SM supported by telehealth confers significant reductions in health care utilisation, including hospitalisation and ED visits.
AuthorsTAYLOR, SJC; Murphy, L; Harrington, P; Teljeur, C; Smith, SM; Pinnock, H; Ryan, M
- Population Health