Supported self-management for COPD: making progress, but there are still challenges.
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Eur Respir J
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Respiratory specialists familiar with the success of supported self-management in asthma  may be excused for feeling disappointed by the evolution of evidence in chronic obstructive pulmonary disease (COPD). The promise of early studies [2–4] was seemingly dashed by a series of negative trials [5, 6] and a trial was even terminated early for fear of a detrimental effect . The most recent Cochrane review, however, concludes that interventions to support self-management reduce respiratory-related and all-cause admissions, reduce dyspnoea and improve quality of life . The interventions in the included studies were heterogeneous and complex; and it was not possible to identify the individual components of supported self-management responsible for effective outcomes. A wider review of trial-level data was also unable to identify the most important components . The study by JONKMAN et al.  in this issue of the European Respiratory Journal, which explores the characteristics of effective self-management interventions in an individual patient data meta-analysis, is therefore a useful contribution to the literature.
AuthorsPinnock, H; Steed, L; Jordan, R
- College Publications