Self management for patients with chronic obstructive pulmonary disease
Open accessAbstract
BACKGROUND: Self management interventions help patients with chronic obstructive pulmonary disease (COPD) acquire and practise the skills they need to carry out disease-specific medical regimens, guide changes in health behaviour and provide emotional support to enable patients to control their disease. Since the first update of this review in 2007, several studies have been published. The results of the second update are reported here. OBJECTIVES: 1. To evaluate whether self management interventions in COPD lead to improved health outcomes.2. To evaluate whether self management interventions in COPD lead to reduced healthcare utilisation. SEARCH METHODS: We searched the Cochrane Airways Group Specialised Register of trials (current to August 2011). SELECTION CRITERIA: Controlled trials (randomised and non-randomised) published after 1994, assessing the efficacy of self management interventions for individuals with COPD, were included. Interventions with fewer than two contact moments between study participants and healthcare providers were excluded. DATA COLLECTION AND ANALYSIS: Two review authors independently assessed trial quality and extracted data. Investigators were contacted to ask for additional information. When appropriate, study results were pooled using a random-effects model. The primary outcomes of the review were health-related quality of life (HRQoL) and number of hospital admissions. MAIN RESULTS: Twenty-nine studies were included. Twenty-three studies on 3189 participants compared self management versus usual care; six studies on 499 participants compared different components of self management on a head-to-head basis. Although we included non-randomised controlled clinical trials as well as RCTs in this review, we restricted the primary analysis to RCTs only and reported these trials in the abstract.In the 23 studies with a usual care control group, follow-up time ranged from two to 24 months. The content of the interventions was diverse. A statistically relevant effect of self management on HRQoL was found (St George's Respiratory Questionnaire (SGRQ) total score, mean difference (MD) -3.51, 95% confidence interval (CI) -5.37 to -1.65, 10 studies, 1413 participants, moderate-quality evidence). Self management also led to a lower probability of respiratory-related hospitalisation (odds ratio (OR) 0.57, 95% CI 0.43 to 0.75, nine studies, 1749 participants, moderate-quality evidence). Over one year of follow-up, eight (95% CI 5 to 14) participants with a high baseline risk of respiratory-related hospital admission needed to be treated to prevent one participant with at least one hospital admission, and 20 (95% CI 15 to 35) participants with a low baseline risk of hospitalisation needed to be treated to prevent one participant with at least one respiratory-related hospital admission.No statistically significant effect of self management on all-cause hospitalisation (OR 0.77, 95% CI 0.45 to 1.30, 6 studies, 1365 participants, low-quality evidence) or mortality (OR 0.79, 95% CI 0.58 to 1.07, 8 studies, 2134 participants, very low-quality evidence) was detected. Also, dyspnoea measured by the (modified) Medical Research Council Scale ((m)MRC) was reduced in individuals who participated in self management (MD -0.83, 95% CI -1.36 to -0.30, 3 studies, 119 participants, low-quality evidence). The difference in exercise capacity as measured by the six-minute walking test was not statistically significant (MD 33.69 m, 95% CI -9.12 to 76.50, 6 studies, 570 participants, very low-quality evidence). Subgroup analyses depending on the use of an exercise programme as part of the intervention revealed no statistically significant differences between studies with and without exercise programmes in our primary outcomes of HRQoL and respiratory-related hospital admissions.We were unable to pool head-to-head trials because of heterogeneity among interventions and controls; thus results are presented narratively within the review. AUTHORS' CONCLUSIONS: Self management interventions in patients with COPD are associated with improved health-related quality of life as measured by the SGRQ, a reduction in respiratory-related hospital admissions, and improvement in dyspnoea as measured by the (m)MRC. No statistically significant differences were found in other outcome parameters. However, heterogeneity among interventions, study populations, follow-up time and outcome measures makes it difficult to formulate clear recommendations regarding the most effective form and content of self management in COPD.
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The most successful interventions for breathlessness are multi-modal, non-pharmacological approaches that work concurrently at multiple points within the brain, respiratory and skeletal system.
“Instead the most successful interventions appear to be multi-modal, non-pharmacological approaches that work concurrently at multiple points within the brain, respiratory and skeletal system.”
From The Breathing, Thinking, Functioning clinical model: a proposal to facilitate evidence-based breathlessness management in chronic respiratory disease (2017) · cites this paper as [23]
The Interventions section describes multicomponent self-management programmes, and the Discussion reports a statistically significant reduction in shortness of breath. But the Discussion says the studies were too different to identify the most effective combination of components. It does not establish that these approaches work concurrently on the brain, respiratory system and skeletal system. (LLM, conf=0.86)
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Cites
Self-efficacy: Toward a unifying theory of behavioral change
Bandura, A. (1977) · Psychological Review · doi:10.1037/0033-295x.84.2.191 · Cited by 43,925 · see citing works
Lozano, R., Naghavi, M., Foreman, K., Lim, S., Shibuya, K., Aboyans, V., Abraham, J., Adair, T., Aggarwal, R., Ahn, S. Y., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61728-0 · Cited by 14,070 · see citing works
Vos, T., Flaxman, A. D., Naghavi, M., Lozano, R., Michaud, C., Ezzati, M., Shibuya, K., Salomon, J. A., Abdalla, S., Aboyans, V., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)61729-2 · Cited by 8,291 · see citing works
Michie, S., Richardson, M., Johnston, M., Abraham, C., Francis, J., Hardeman, W., Eccles, M. P., Cane, J., & Wood, C. E. (2013) · Annals of Behavioral Medicine · doi:10.1007/s12160-013-9486-6 · Cited by 7,629 · see citing works
Self-management education: History, definition, outcomes, and mechanisms
Lorig, K. R., & Holman, H. R. (2003) · Annals of Behavioral Medicine · doi:10.1207/s15324796abm2601_01 · Cited by 4,094 · see citing works
Lorig, K. R., Sobel, D. S., Stewart, A. L., Brown, B. W., Bandura, A., Ritter, P., Gonzalez, V. M., Laurent, D. D., & Holman, H. R. (1999) · Medical Care · doi:10.1097/00005650-199901000-00003 · Cited by 2,261 · see citing works
Holland, A. E., Hill, C. J., Rasekaba, T., Lee, A., Naughton, M. T., & McDonald, C. F. (2010) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2009.10.017 · Cited by 487 · see citing works
Emery, C. F., Schein, R. L., Hauck, E. R., & MacIntyre, N. R. (1998) · Health Psychology · doi:10.1037/0278-6133.17.3.232 · Cited by 353 · see citing works
Fan, V. S., Gaziano, J. M., Lew, R., Bourbeau, J., Adams, S. G., Leatherman, S., Thwin, S. S., Huang, G. D., Robbins, R., Sriram, P. S., et al. (2012) · Annals of Internal Medicine · doi:10.7326/0003-4819-156-10-201205150-00003 · Cited by 338 · see citing works
Bucknall, C. E., Miller, G., Lloyd, S. M., Cleland, J., McCluskey, S., Cotton, M., Stevenson, R. D., Cotton, P., & McConnachie, A. (2012) · BMJ · doi:10.1136/bmj.e1060 · Cited by 226 · see citing works
Kunik, M. E., Veazey, C., Cully, J. A., Souchek, J., Graham, D. P., Hopko, D., Carter, R., Sharafkhaneh, A., Goepfert, E. J., Wray, N., et al. (2008) · Psychological Medicine · doi:10.1017/s0033291707001687 · Cited by 214 · see citing works
Pilot study of a cell phone-based exercise persistence intervention post-rehabilitation for COPD
Nguyen, H. (2009) · International Journal of Chronic Obstructive Pulmonary Disease · doi:10.2147/copd.s6643 · Cited by 165 · see citing works
Bischoff, E. W. M. A., Akkermans, R., Bourbeau, J., van Weel, C., Vercoulen, J. H., & Schermer, T. R. J. (2012) · BMJ · doi:10.1136/bmj.e7642 · Cited by 137 · see citing works
Evaluation of a self-management plan for chronic obstructive pulmonary disease
Watson, P., Town, G., Holbrook, N., Dwan, C., Toop, L., & Drennan, C. (1997) · European Respiratory Journal · doi:10.1183/09031936.97.10061267 · Cited by 132 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Vogelmeier, C. F., Criner, G. J., Martínez, F. J., Anzueto, A., Barnes, P. J., Bourbeau, J., Celli, B. R., Chen, R., Decramer, M., Fabbri, L. M., et al. (2017) · European Respiratory Journal · doi:10.1183/13993003.00214-2017 · Cited by 885 · see citing works
Self-citationVogelmeier, C. F., Criner, G. J., Martinez, F. J., Anzueto, A., Barnes, P. J., Bourbeau, J., Celli, B. R., Chen, R., Decramer, M., Fabbri, L. M., et al. (2017) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201701-0218pp · Cited by 3,187 · see citing works
“Self-management interventions that use written negotiated action plans for worsening symptoms may lead to less respiratory-related hospitalization and all cause hospitalizations and improved health status.(188) The health benefits of COPD self-management programs may be negated by increased mortality.”
BackgroundSelf-citationVogelmeier, C. F., Criner, G. J., Martínez, F. J., Anzueto, A., Barnes, P. J., Bourbeau, J., Celli, B. R., Chen, R., Decramer, M., Fabbri, L. M., et al. (2017) · Respirology · doi:10.1111/resp.13012 · Cited by 684 · see citing works
Self-citationRochester, C., Vogiatzis, I., Holland, A., Lareau, S., Marciniuk, D., Puhan, M., Spruit, M., Masefield, S., Casaburi, R., Clini, E., et al. (2015) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.201510-1966st · Cited by 808 · see citing works
“Concurrent behavioral interventions, such as promoting self-efficacy and teaching collaborative self-management skills, are also integral to optimizing patient outcomes (83, 84).”
BackgroundInterventions to Support Behavioral Self-Management of Chronic Diseases
Allegrante, J. P., Wells, M. T., & Peterson, J. C. (2019) · Annual Review of Public Health · doi:10.1146/annurev-publhealth-040218-044008 · Cited by 502 · see citing works
Viniol, C., & Vogelmeier, C. (2018) · European Respiratory Review · doi:10.1183/16000617.0103-2017 · Cited by 430 · see citing works
Telerehabilitation for chronic respiratory disease
Cox, N., McDonald, C., Hill, C., O'Halloran, P., Alison, J., Zanaboni, P., Macdonald, H., & Holland, A. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013040 · Cited by 369 · see citing works
Vogelmeier, C. F., Criner, G. J., Martínez, F. J., Anzueto, A., Barnes, P. J., Bourbeau, J., Celli, B. R., Chen, R., Decramer, M., Fabbri, L. M., et al. (2017) · Archivos de Bronconeumología · doi:10.1016/j.arbres.2017.02.001 · Cited by 311 · see citing works
Self-citationGoals of COPD treatment: Focus on symptoms and exacerbations
Vogelmeier, C. F., Román-Rodríguez, M., Singh, D., Han, M. K., Rodriguez‐Roisin, R., & Ferguson, G. T. (2020) · Respiratory Medicine · doi:10.1016/j.rmed.2020.105938 · Cited by 374 · see citing works
Lenferink, A., Brusse-Keizer, M., van der Valk, P. D., Frith, P. A., Zwerink, M., Monninkhof, E. M., van der Palen, J., & Effing, T. W. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011682.pub2 · Cited by 328 · see citing works
Self-citationKo, F., Chan, K. P., Hui, D., Goddard, J., Shaw, J., Reid, D., & Yang, I. (2016) · Respirology (Carlton South. Print) · doi:10.1111/resp.12780 · Cited by 327 · see citing works
“92 , 96 Ko et al recently reported an audit of patients undergoing a 16-week comprehensive COPD care programme shortly post-AECOPD and found that patients had a reduction in hospital admissions at 1 year after the programme compared with the year prior to the commencement of programme.”
BackgroundResultPrevention of Acute Exacerbations of COPD
Criner, G. J., Bourbeau, J., Diekemper, R. L., Ouellette, D. R., Goodridge, D. M., Hernandez, P., Curren, K., Balter, M. S., Bhutani, M., Camp, P. G., et al. (2014) · CHEST Journal · doi:10.1378/chest.14-1676 · Cited by 290 · see citing works
Impact and prevention of severe exacerbations of COPD: a review of the evidence
Halpin, D., Miravitlles, M., Metzdorf, N., & Celli, B. (2017) · International Journal of COPD · doi:10.2147/copd.s139470 · Cited by 252 · see citing works
“…review suggested that overall, the balance of evidence supports the use of self-management programs to reduce the probability of respiratory-related hospitalizations, 111 and the American College of Chest Physicians and Canadian Thoracic Society 107 and ATS/ERS guidelines 12 advocate their use.”
Spathis, A., Booth, S., Moffat, C., Hurst, R., Ryan, R., Chin, C., & Burkin, J. (2017) · npj Primary Care Respiratory Medicine · doi:10.1038/s41533-017-0024-z · Cited by 226 · see citing works
Definition of a COPD self-management intervention: International Expert Group consensus
Effing, T., Vercoulen, J., Bourbeau, J., Trappenburg, J., Lenferink, A., Cafarella, P. A., Coultas, D., Meek, P., van der Valk, P., Bischoff, E., et al. (2016) · European Respiratory Journal · doi:10.1183/13993003.00025-2016 · Cited by 224 · see citing works
“Besides the pathophysiological causes of COPD, poor self-management behaviours are believed to have a significant influence on symptoms, functional impairments and quality of life [6].”
InfluentialSelf-citationMccabe, C., McCann, M., & Brady, A. (2017) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011425.pub2 · Cited by 221 · see citing works
Asthma–COPD overlap 2015: now we are six
Gibson, P., & McDonald, V. (2015) · Thorax · doi:10.1136/thoraxjnl-2014-206740 · Cited by 207 · see citing works
“Self-management programmes for both asthma and COPD have proven effective; however, asthma self-management programmes are not directly transferrable to patients with COPD, 94 and careful selection of patients with COPD is required to avoid harm.”
Russell, S., Ogunbayo, O. J., Newham, J. J., Heslop-Marshall, K., Netts, P., Hanratty, B., Beyer, F. R., & Kaner, E. (2018) · npj Primary Care Respiratory Medicine · doi:10.1038/s41533-017-0069-z · Cited by 165 · see citing works
“Indeed, self-management interventions incorporating behaviour change techniques targeting mental health have been shown to be more effective than those that focus on symptom management alone.(17,20) There was heterogeneity across the self-management definitions identified in this review.”
BackgroundCOPD Readmissions: Addressing COPD in the Era of Value-based Health Care.
Shah, T., Press, V., Huisingh-Scheetz, M., & White, S. (2016) · Chest · doi:10.1016/j.chest.2016.05.002 · Cited by 156 · see citing works
“A recent Cochrane review verifies that successful patient self-management in COPD is associated with a reduction in both respiratoryrelated and all-cause readmissions.(60) Studies on selfmanagement varied by educational focus on some but not necessarily all of the following topics: COPD as a disease, action plans, exe…”
BackgroundHanania, N. A., & O’Donnell, D. E. (2019) · International Journal of COPD · doi:10.2147/copd.s188141 · Cited by 150 · see citing works
Yang, I. A., Brown, J., George, J., JENKINS, S. C., McDonald, C. F., McDonald, V. M., Phillips, K., Smith, B. J., Zwar, N. A., & Dabscheck, E. J. (2017) · The Medical Journal of Australia · doi:10.5694/mja17.00686 · Cited by 148 · see citing works
Koetsenruijter, J., van Eikelenboom, N., van Lieshout, J., Vassilev, I., Lionis, C., Todorova, E., Portillo, M. C., Foss, C., Serrano Gil, M., Roukova, P., et al. (2016) · Patient Education and Counseling · doi:10.1016/j.pec.2015.10.029 · Cited by 135 · see citing works
An architecture and protocol for smart continuous eHealth monitoring using 5G
Lloret, J., Parra, L., Taha, M., & Tomás, J. (2017) · Computer Networks · doi:10.1016/j.comnet.2017.05.018 · Cited by 164 · see citing works
Action plans with brief patient education for exacerbations in chronic obstructive pulmonary disease
Howcroft, M., Walters, E. H., Wood-Baker, R. R., & Walters, J. A. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd005074.pub4 · Cited by 137 · see citing works
Baird, C., Lovell, J., Johnson, M., Shiell, K., & Ibrahim, J. (2017) · Respiratory Medicine · doi:10.1016/j.rmed.2017.06.006 · Cited by 122 · see citing works
Kaptein, A. A., Fischer, M. J., & Scharloo, M. (2014) · International Journal of COPD · doi:10.2147/copd.s49622 · Cited by 107 · see citing works
“In line with the aforementioned ATS/ERS statement on PR, the most rigorous review to date about self-management for patients with COPD states that the goal of self-management training should be to establish sustainable behavioral change.(42) However, this review concentrated mainly on such clinical outcomes as hospita…”
BackgroundResultBentley, C. L., Powell, L., Potter, S., Parker, J., Mountain, G. A., Bartlett, Y. K., Farwer, J., O’Connor, C. A., Burns, J., Cresswell, R. L., et al. (2020) · JMIR mhealth and uhealth · doi:10.2196/16203 · Cited by 138 · see citing works
“Even with appropriate medical care, people with COPD experience symptoms and functional challenges on a daily basis, and therefore, they must engage in long-term self-management to maintain their physical, social, and psychological health [8,9].”
BackgroundFarmer, A. A., Williams, V., Velardo, C., Shah, S. A., Yu, L., Rutter, H., Jones, L., Williams, N., Heneghan, C. J., Price, J. R., et al. (2017) · Journal of Medical Internet Research · doi:10.2196/jmir.7116 · Cited by 124 · see citing works
“Although COPD-specific health status is an important aspect of COPD that has been shown to be responsive to group and one-to-one interventions [50], a digital health intervention used on its own may not replace a more intensive and personalized intervention for many patients.”
BackgroundBusby, J., Purdy, S., & Hollingworth, W. (2015) · BMC Health Services Research · doi:10.1186/s12913-015-0964-3 · Cited by 113 · see citing works
Aboumatar, H., Naqibuddin, M., Chung, S., Chaudhry, H., Kim, S. W., Saunders, J., Lee, B.-N. R., Gurses, A., Knowlton, A., Pronovost, P., et al. (2019) · Journal of the American Medical Association (JAMA) · doi:10.1001/jama.2019.11982 · Cited by 110 · see citing works
Wray, F., & Clarke, D. J. (2017) · BMJ Open · doi:10.1136/bmjopen-2017-017944 · Cited by 121 · see citing works
“141 142 There is evidence to support the use of self-management interventions in a range of chronic conditions 143–146 and there is a substantial policy drive towards taking this approach in stroke care.”
BackgroundSullivan, D. R., Iyer, A. S., Enguidanos, S. M., Cox, C. E., Farquhar, M. C., Janssen, D. J. A., Lindell, K. O., Mularski, R. A., Smallwood, N., Turnbull, A. E., et al. (2022) · American Journal of Respiratory and Critical Care Medicine · doi:10.1164/rccm.202207-1262st · Cited by 134 · see citing works
“Among patients with serious respiratory illness, components of self-care interventions include recognition and treatment of exacerbations, physical activity and exercise behaviors, and education and tools to self-manage symptoms such as breathlessness (164, 167).”
BackgroundA systematic review of the effectiveness of discharge care bundles for patients with COPD
Ospina, M. B., Mrklas, K., Deuchar, L., Rowe, B. H., Leigh, R., Bhutani, M., & Stickland, M. K. (2016) · Thorax · doi:10.1136/thoraxjnl-2016-208820 · Cited by 106 · see citing works
Meeting the challenge of COPD care delivery in the USA: a multiprovider perspective
Han, M. K., Martinez, C. H., Au, D. H., Bourbeau, J., Boyd, C. M., Branson, R. D., Criner, G. J., Kalhan, R., Kallstrom, T. J., King, A., et al. (2016) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(16)00094-1 · Cited by 108 · see citing works
Murphy, L. A., Harrington, P., Taylor, S. J., Teljeur, C., Smith, S. M., Pinnock, H., & Ryan, M. (2017) · Chronic Respiratory Disease · doi:10.1177/1479972316687208 · Cited by 93 · see citing works
“Three reviews reported on hospitalization with evidence rated as moderate, two showed a significant reduction.(20,21) One out of three reviews reported a significant reduction in emergency department (ED) visits.”
BackgroundInfluentialSelf management of patients with mild COPD in primary care: randomised controlled trial
Jolly, K. B., Sidhu, M. S., Hewitt, C. A., Coventry, P. A., Daley, A., Jordan, R. E., Heneghan, C. J., Singh, S., Ives, N. J., Adab, P., et al. (2018) · BMJ · doi:10.1136/bmj.k2241 · Cited by 118 · see citing works
Patient-mediated interventions to improve professional practice
Fønhus, M. S., Dalsbø, T. K., Johansen, M., Fretheim, A., Skirbekk, H., & Flottorp, S. A. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012472.pub2 · Cited by 107 · see citing works
Cannon, D., Buys, N., Sriram, K., Sharma, S., Morris, N., & Sun, J. (2016) · Respiratory Medicine · doi:10.1016/j.rmed.2016.11.005 · Cited by 97 · see citing works
Jonkman, N. H., Schuurmans, M. J., Groenwold, R. H. H., Hoes, A. W., & Trappenburg, J. C. A. (2016) · Patient Education and Counseling · doi:10.1016/j.pec.2016.01.022 · Cited by 101 · see citing works
Jordan, R., Adab, P., Sitch, A., Enocson, A., Blissett, D., Jowett, S., Marsh, J., Riley, R., Miller, M. R., Cooper, B., et al. (2016) · The Lancet Respiratory Medicine · doi:10.1016/s2213-2600(16)30149-7 · Cited by 94 · see citing works
Newham, J., Presseau, J., Heslop-Marshall, K., Russell, S., Ogunbayo, O., Netts, P., Hanratty, B., & Kaner, E. (2017) · International Journal of Chronic Obstructive Pulmonary Disease · doi:10.2147/copd.s133317 · Cited by 93 · see citing works
“Zwerink et al 7 and Jonkman et al 10 were the only reviews to conduct subgroup analyses to quantify what content of SMIs are most effective.”
InfluentialDistinguishing adult-onset asthma from COPD: a review and a new approach
Abramson, M. J., Perret, J. L., Dharmage, S. C., McDonald, V. M., & McDonald, C. F. (2014) · International Journal of COPD · doi:10.2147/copd.s46761 · Cited by 82 · see citing works
“recommendations regarding the form and contents of SME programs in COPD.(130) Another systematic review concluded”
Korpershoek, Y. J. G., Vervoort, S. C. J. M., Trappenburg, J. C. A., & Schuurmans, M. J. (2018) · BMC Health Services Research · doi:10.1186/s12913-018-3545-4 · Cited by 87 · see citing works
“The absence of an adequate imminent exacerbation marker requires to focus on supporting COPD patients in developing self-management skills to be able to adequately detect exacerbations and to take prompt actions and thereby reduce the impact of exacerbations [9, 10].”
BackgroundSelzler, A., Wald, J., Sedeno, M. F., Jourdain, T., Janaudis‐Ferreira, T., Goldstein, R. S., Bourbeau, J., & Stickland, M. K. (2017) · Chronic Respiratory Disease · doi:10.1177/1479972317724570 · Cited by 95 · see citing works
“There is evidence to suggest that self-management training in conjunction with PR translates into positive outcomes, including improved quality of life, dyspnea, and healthcare utilization.(43,44) The purpose of self-management education within PR is to guide patients through the acquisition and implementation of skil…”
BackgroundKo, F. W. S., Cheung, N.-K., Rainer, T., Lum, C., Wong, I., & Hui, D. S. C. (2016) · Thorax · doi:10.1136/thoraxjnl-2016-208396 · Cited by 84 · see citing works
“19 In this Cochrane Review, only one 28 among the 23 studies involved patients immediately after an AECOPD.”
BackgroundO'Conor, R., Muellers, K., Arvanitis, M., Vicencio, D., Wolf, M., Wisnivesky, J., & Federman, A. (2019) · Respiratory Medicine · doi:10.1016/j.rmed.2019.02.006 · Cited by 83 · see citing works
The best person (or machine) for the job: Rethinking task shifting in healthcare
van Schalkwyk, M. C., Bourek, A., Kringos, D. S., Siciliani, L., Barry, M. M., Maeseneer, J. D., & McKee, M. (2020) · Health Policy · doi:10.1016/j.healthpol.2020.08.008 · Cited by 98 · see citing works
COVID-19 related concerns of people with long-term respiratory conditions: a qualitative study
Philip, K. E. J., Lonergan, B., Cumella, A., Farrington-Douglas, J., Laffan, M., & Hopkinson, N. S. (2020) · BMC Pulmonary Medicine · doi:10.1186/s12890-020-01363-9 · Cited by 88 · see citing works
Benzo, R., abascal-Bolado, B., & Dulohery, M. (2015) · Patient Education and Counseling · doi:10.1016/j.pec.2015.10.031 · Cited by 80 · see citing works
“Recent data suggest that the effectiveness of SM programs may be limited if they are not incorporated in a more extensive individualized assessment of the whole patient that goes beyond the specificities of disease, COPD in this case (4).”
BackgroundResultInfluentialYang, F., Wang, Y.-C., Yang, C.-M., Hu, H., & Xiong, Z.-F. (2018) · BMC Pulmonary Medicine · doi:10.1186/s12890-018-0671-z · Cited by 79 · see citing works
Entwistle, V. A., Cribb, A., & Owens, J. (2016) · Health Care Analysis · doi:10.1007/s10728-016-0335-1 · Cited by 82 · see citing works
“But despite some strikingly positive reports of what some forms of self-management support have achieved in some outcome domains for some people, efforts to enhance support for self-management, and especially that delivered by health professionals in the context of routine service provision, have often proven difficul…”
Long-term evaluation of home-based pulmonary rehabilitation in patients with COPD
Wallaert, B., Grosbois, J., Gicquello, A., Langlois, C., Rouzic, O. L., Chenivesse, C., & Bart, F. (2015) · International Journal of COPD · doi:10.2147/copd.s90534 · Cited by 75 · see citing works
“Self-management, which comprises medical and behavioral support, life-role support, and emotional support, has been shown to be useful in patients with COPD in terms of improvement of dyspnea and quality of life and decreased hospitalization rates for respiratory problems.(18,20,38) Active involvement of the spouse an…”
BackgroundKorpershoek, Y. J. G., Hermsen, S., Schoonhoven, L., Schuurmans, M. J., & Trappenburg, J. C. A. (2020) · Journal of Medical Internet Research · doi:10.2196/15449 · Cited by 78 · see citing works
“Self-management interventions, including exacerbation action plans along with ongoing self-management support, were associated with positive outcomes on quality of life, hospital admissions, and health care use [11,12,60].”
BackgroundIovino, P., Lyons, K., Maria, M. D., Vellone, E., Ausili, D., Lee, C. S., Riegel, B., & Matarese, M. (2020) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2020.103574 · Cited by 77 · see citing works
Zwar, N., Bunker, J., Reddel, H., Dennis, S., Middleton, S., van Schayck, O. V., Crockett, A., Hasan, I., Hermiz, O. S., Vagholkar, S., et al. (2016) · Family Practice · doi:10.1093/fampra/cmw077 · Cited by 77 · see citing works
Geographic Accessibility of Pulmonologists for Adults With COPD
Croft, J., Lu, H., Zhang, X.-Y., & Holt, J. (2016) · Chest · doi:10.1016/j.chest.2016.05.014 · Cited by 73 · see citing works
Comprehensive Self-Management Strategies
Bourbeau, J., Lavoie, K., & Sedeno, M. (2015) · Seminars in Respiratory and Critical Care Medicine · doi:10.1055/s-0035-1556059 · Cited by 73 · see citing works
Determinants of activation for self-management in patients with COPD
Korpershoek, Y., Bos-Touwen, I. D., Ginkel, J. M. D. M., Lammers, J. J., Schuurmans, M. J., & Trappenburg, J. C. A. (2016) · International Journal of COPD · doi:10.2147/copd.s109016 · Cited by 79 · see citing works
“Previous research has shown that self-management interventions have positive effects on disease outcomes, healthrelated quality of life, and health care costs.(5,11,12) A substantial proportion of COPD patients, however, do not respond or comply with self-management interventions.”
Jonkman, N., Westland, H., Trappenburg, J. C., Groenwold, R. H., Bischoff, E. W., Bourbeau, J., Bucknall, C. E., Coultas, D., Effing, T. W., Epton, M., et al. (2016) · International Journal of Chronic Obstructive Pulmonary Disease · doi:10.2147/copd.s107884 · Cited by 71 · see citing works
“There is general agreement on the multifaceted nature of selfmanagement interventions.(3,4,14) Therefore, self-management interventions were defined as interventions providing information to patients and including minimally two of the following components: 1) stimulation of sign/symptom monitoring, 2) education in pro…”
InfluentialSelf-citationBlackstock, F. C., Lareau, S. C., Nici, L. L., ZuWallack, R., Bourbeau, J., Buckley, M. L., Durning, S. J., Effing, T., Egbert, E., Goldstein, R. S., et al. (2018) · Annals of the American Thoracic Society · doi:10.1513/annalsats.201804-253ws · Cited by 86 · see citing works
Self-citationJonkman, N. H., Westland, H., Trappenburg, J. C. A., Groenwold, R. H. H., Bischoff, E. W. M. A., Bourbeau, J., Bucknall, C. E., Coultas, D., Effing, T., Epton, M., et al. (2016) · European Respiratory Journal · doi:10.1183/13993003.01860-2015 · Cited by 75 · see citing works
Self-citationAn artificial intelligence approach to early predict symptom-based exacerbations of COPD
Fernandez-Granero, M. A., Morillo, D., & León‐Jiménez, A. (2018) · Biotechnology & Biotechnological Equipment · doi:10.1080/13102818.2018.1437568 · Cited by 78 · see citing works
“A recent Cochrane review has described potential advantages of self-management interventions in COPD [8].”
BackgroundJung, T. H., Moorhouse, N., Shi, X., & Amin, M. F. (2020) · Journal of Medical Internet Research · doi:10.2196/14178 · Cited by 76 · see citing works
“In addition, self-management interventions could lead to a reduction in COPD-related health costs by reducing hospital admissions [61-63].”
The impact of integrated disease management in high-risk COPD patients in primary care
Ferrone, M., Masciantonio, M. G., Malus, N., Stitt, L., O’Callahan, T., Roberts, Z., Johnson, L., Samson, J., Durocher, L., Ferrari, M., et al. (2019) · npj Primary Care Respiratory Medicine · doi:10.1038/s41533-019-0119-9 · Cited by 68 · see citing works
Jónsdóttir, H., Ámundadóttir, Ó. R., Guðmundsson, G., Halldorsdottir, B. S., Hrafnkelsson, B., Ingadóttir, T. S., Jónsdóttir, R., Jónsson, J. S., Sigurjonsdottir, E. D., & Stefansdottir, I. (2015) · Journal of Advanced Nursing · doi:10.1111/jan.12728 · Cited by 66 · see citing works
“However, scientists have been cautious in drawing firm conclusions about the effectiveness of selfmanagement programmes (SMP), partly due to heterogeneity in the content and structure of the interventions and the methodology that has been used to study them (Effing et al. 2007, Zwerink et al. 2014).”
BackgroundMethodO’Connell, S., Mc Carthy, V. J. C., & Savage, E. (2018) · BMC Health Services Research · doi:10.1186/s12913-018-3387-0 · Cited by 68 · see citing works
“Differences in courses of action may be to some extent attributed to inconclusive evidence on SMS approaches [5, 20].”
The Importance of Self-Management in the Context of Personalized Care in COPD
Cravo, A., Attar, D., Freeman, D., Holmes, S., Ip, L., & Singh, S. J. (2022) · International Journal of COPD · doi:10.2147/copd.s343108 · Cited by 72 · see citing works
“82,83 Future studies should aim to standardize the study methodology and outcomes used in this area of research in order to increase the comparability of future trials.”
MethodImproving the quality of life of people with advanced respiratory disease and severe breathlessness
Booth, S., & Johnson, M. J. (2019) · Breathe · doi:10.1183/20734735.0200-2019 · Cited by 79 · see citing works
“Fortunately, many of the treatments for breathlessness help fatigue as well, particularly exercise, cognitive behavioural therapy and pacing and prioritising [72].”
Backgroundvan der Molen, T., van Boven, J. V., Maguire, T., Goyal, P., & Altman, P. (2016) · British Journal of Clinical Pharmacology · doi:10.1111/bcp.13087 · Cited by 67 · see citing works
Chronic obstructive pulmonary disease comorbidities
Brown, J. P., & Martinez, C. (2016) · Current opinion in pulmonary medicine · doi:10.1097/mcp.0000000000000241 · Cited by 67
“Clinical outcomes are worse for study participants with anxiety or depression, compared with COPD patients without these comorbidities, including higher economic burden [59], hospital readmissions [60 & ], and interference with successful disease self-management [61].”
BackgroundMc Cord, K. A., Ewald, H., Agarwal, A., Glinz, D., Aghlmandi, S., Ioannidis, J. P. A., & Hemkens, L. G. (2021) · BMJ · doi:10.1136/bmj.n450 · Cited by 61 · see citing works
Baker, E., & Fatoye, F. (2017) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2017.03.010 · Cited by 64 · see citing works
Yang, F., Xiong, Z.-F., Yang, C.-M., Li, L., Qiao, G., Wang, Y.-C., Zheng, T., He, H.-J., & Hu, H. (2017) · COPD · doi:10.1080/15412555.2016.1256384 · Cited by 64 · see citing works
“This was similar with two systematic reviews, which showed that simple self-management education without support was not effective (70), but supported self-management interventions could be effective in reducing respiratory admissions among stable COPD patients (71).”
Self-management of health care behaviors for COPD: a systematic review and meta-analysis
Jolly, K. B., Majothi, S., Sitch, A. J., Heneghan, N. R., Moore, D., Riley, R. D., Bates, E. J., Turner, A. M., Bayliss, S. E., Price, M. J., et al. (2016) · International Journal of COPD · doi:10.2147/copd.s90812 · Cited by 64 · see citing works
“Our study differs from many other systematic reviews 14,20,22 in reporting follow-up at three time points.”
Self-management following an acute exacerbation of COPD: a systematic review.
Harrison, S., Janaudis-Ferreira, T., Brooks, D., Desveaux, L., & Goldstein, R. (2015) · Chest · doi:10.1378/chest.14-1658 · Cited by 64 · see citing works
Lee, C. S., Westland, H., Faulkner, K. M., Iovino, P., Thompson, J. H., Sexton, J., Farry, E., Jaarsma, T., & Riegel, B. J. (2022) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2022.104322 · Cited by 70 · see citing works
Matarese, M., Clari, M., Marinis, M. G. D., Barbaranelli, C., Ivziku, D., Piredda, M., & Riegel, B. J. (2019) · Evaluation & the Health Professions · doi:10.1177/0163278719856660 · Cited by 70 · see citing works
“Evidence has shown that effective self-care can improve health-related quality of life and reduce respiratoryrelated hospital admissions (Lenferink et al., 2017; Zwerink et al., 2014) and the utilization of health-care services (Murphy et al., 2017).”
BackgroundSelf-Care of People with Chronic Obstructive Pulmonary Disease: A Meta-Synthesis
Clari, M., Matarese, M., Ivziku, D., & Marinis, M. G. D. (2017) · Patient · doi:10.1007/s40271-017-0218-z · Cited by 78 · see citing works
Majothi, S., Jolly, K., Heneghan, N., Price, M., Riley, R., Turner, A., Bayliss, S., Moore, D., Singh, S. J., Adab, P., et al. (2015) · International Journal of COPD · doi:10.2147/copd.s74162 · Cited by 63 · see citing works
“A recent systematic review has shown that supported self-management interventions can be effective in reducing future respiratory admissions among stable COPD patients, 3 although simple self-management education without support is not effective.”
BackgroundTighe, S. A., Ball, K., Kensing, F., Kayser, L., Rawstorn, J. C., & Maddison, R. (2020) · Journal of Medical Internet Research · doi:10.2196/16774 · Cited by 68 · see citing works
“Despite the proven effectiveness of secondary prevention [12,22-24], uptake and adherence to structured face-to-face programs is suboptimal [25-29].”
Wang, L.-H., Guo, Y., Wang, M., & Zhao, Y. (2020) · Clinical Rehabilitation · doi:10.1177/0269215520946931 · Cited by 62 · see citing works
Slevin, P., Kessie, T., Cullen, J., Butler, M. W., Donnelly, S. C., & Caulfield, B. (2019) · Digital Health · doi:10.1177/2055207619871729 · Cited by 66 · see citing works
Wray, F., Clarke, D., & Forster, A. (2018) · Disability and Rehabilitation · doi:10.1080/09638288.2017.1294206 · Cited by 61 · see citing works
Morrison, D., Mair, F. S., Yardley, L., Kirby, S. E., & Thomas, M. D. (2016) · Chronic Respiratory Disease · doi:10.1177/1479972316660977 · Cited by 54 · see citing works
“Focusing on COPD, a recent Cochrane systematic review has demonstrated that self-management improves health-related QOL, reduces respiratoryrelated hospital admissions and improves levels of dyspnoea.(8) However, due to heterogeneity, they were unable to be specific about what was the most effective form and content o…”
BackgroundInfluentialArtificial intelligence in respiratory care: Current scenario and future perspective
Al-Anazi, S., Al‐Omari, A., Alanazi, S., Marar, A., As’ad, M., Alawaji, F., & Alwateid, S. (2024) · Annals of Thoracic Medicine · doi:10.4103/atm.atm_192_23 · Cited by 72 · see citing works
“Respiratory therapy programs, smoking cessation, patient education, digital health tools, and predictive modeling [21] ECMO=Extracorporeal membrane oxygenation”
MethodFeature engineering for sentiment analysis in e-health forums
Carrillo-de-Albornoz, J., Rodríguez-Vidal, J., & Plaza, L. (2018) · PLoS ONE · doi:10.1371/journal.pone.0207996 · Cited by 60 · see citing works
Kouijzer, M., Brusse-Keizer, M., & Bode, C. (2018) · Respiratory Medicine · doi:10.1016/j.rmed.2018.06.011 · Cited by 60 · see citing works
Self-citationCameron-Tucker, H., Wood-Baker, R. R., Joseph, L., Walters, J. A., Schüz, N., & Walters, E. H. (2016) · International Journal of COPD · doi:10.2147/copd.s109820 · Cited by 62 · see citing works
“Others have similarly concluded that self-management focusing on education(36) or self-management per se has minimal effect on physical capacity.(37) Our data support the conclusions of the latter authors that this is due to participants not exercising at sufficient intensity and, as our results indicate, not walking…”
Management of the COPD Patient with Comorbidities: An Experts Recommendation Document
Iglesias, J. R., Díez‐Manglano, J., Garcı́a, F. L., Peromingo, J. A. D., Almagro, P., & Aguilar, J. M. V. (2020) · International Journal of COPD · doi:10.2147/copd.s242009 · Cited by 74 · see citing works
Rose, L., Istanboulian, L., Carriere, L., Thomas, A., Lee, H.-B., Rezaie, S., Shafai, R., & Fraser, I. (2018) · European Respiratory Journal · doi:10.1183/13993003.01567-2017 · Cited by 61 · see citing works
Factors influencing exacerbation-related self-management in patients with COPD: a qualitative study
Korpershoek, Y., Vervoort, S., nijssen, L., Trappenburg, J., & Schuurmans, M. (2016) · International Journal of COPD · doi:10.2147/copd.s116196 · Cited by 57 · see citing works
“16,44 HCPs should be aware that these patients might express limited needs regarding self-management support themselves.”
Burton, C. D., Pinnock, H., & McKinstry, B. (2014) · Journal of Telemedicine and Telecare · doi:10.1177/1357633x14562733 · Cited by 59 · see citing works
“Third, the difficulty in identifying exacerbations may be one factor in the equivocal outcomes of trials of selfmanagement in COPD which expect patients to detect and commence treatment for exacerbations.(15,16) This difficulty may be the reason for the positive results in some more intensive programmes,(17) compared…”
ResultCoultas, D., Jackson, B. E., Russo, R., Peoples, J., Singh, K. P., Sloan, J., Uhm, M., Ashmore, J., Blair, S., & Bae, S. (2017) · Annals of the American Thoracic Society · doi:10.1513/annalsats.201704-308oc · Cited by 55 · see citing works
Budhwani, S., Wodchis, W. P., Zimmermann, C., Moineddin, R., & Howell, D. (2018) · BMJ Supportive & Palliative Care · doi:10.1136/bmjspcare-2018-001529 · Cited by 64 · see citing works
Yadav, U. N., Lloyd, J., Hosseinzadeh, H., Baral, K., & Harris, M. (2020) · Journal of Clinical Medicine · doi:10.3390/jcm9030646 · Cited by 53 · see citing works
“Self-management programs have been demonstrated to slow down the worsening symptoms, prevent exacerbations, and improve quality of life [3].”
BackgroundResultSelf-management for bronchiectasis.
Kelly, C., Grundy, S., Lynes, D., Evans, D. J., Gudur, S., Milan, S., & Spencer, S. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012528.pub2 · Cited by 52 · see citing works
Exacerbation action plans for patients with COPD and comorbidities: a randomised controlled trial
Lenferink, A., van der Palen, J. A. M., van der Valk, P. D. L. P. M., Cafarella, P., van Veen, A., Quinn, S. J., Groothuis‐Oudshoorn, C. G. M., Burt, M. G., Young, M., Frith, P. A., et al. (2019) · European Respiratory Journal · doi:10.1183/13993003.02134-2018 · Cited by 57 · see citing works
Self-citationYadav, U. N., Hosseinzadeh, H., Lloyd, J., & Harris, M. (2018) · Chronic Respiratory Disease · doi:10.1177/1479973118816418 · Cited by 51 · see citing works
“Chronic obstructive pulmonary disease (COPD) selfmanagement involves self-recognition and management of symptoms, taking medication and eating a healthy diet, coping with breathlessness, quitting smoking and engaging in regular physical exercise to maintain good health.(1) Self-management interventions improve COPD he…”
BackgroundAboumatar, H., Naqibuddin, M., Chung, S., Chaudhry, H., Kim, S. W., Saunders, J., Lee, B.-N. R., Gurses, A., Knowlton, A., Pronovost, P., et al. (2018) · Journal of the American Medical Association (JAMA) · doi:10.1001/jama.2018.17933 · Cited by 51 · see citing works
RetractedBenzo, R., Kirsch, J., Dulohery, M., & abascal-Bolado, B. (2016) · Annals of the American Thoracic Society · doi:10.1513/annalsats.201508-490oc · Cited by 51 · see citing works
- Authors
- Zwerink, M., Brusse-Keizer, M., van der Valk, P. D., Zielhuis, G. A., Monninkhof, E. M., van der Palen, J., Frith, P. A., & Effing, T.
- Affiliations
- Medisch Spectrum Twente (NL)
- Medisch Spectrum Twente; Department of Pulmonary Medicine; Haaksbergerstraat 55 Enschede Netherlands 7513 ER
- Radboud University Medical Center (NL)
- University Medical Center Utrecht (NL)
- Flinders University (AU)
- Venue
- Cochrane Database of Systematic Reviews
- Publisher
- Wiley
- Published
- 2014-03-24
- Issue
- 3
- Pages
- CD002990-CD002990
- ISSN
- 1361-6137 (ISSN-L)
- 1465-1858
- PMC
- PMC7004246
- OpenAlex
- W2100389803
- Cited by
- 572
- References
- 0
- Citations by year
- 2026: 11 · 2025: 13 · 2024: 27 · 2023: 30 · 2022: 40 · 2021: 50 · 2020: 69 · 2019: 59 · 2018: 73 · 2017: 87 · 2016: 62 · 2015: 32 · 2014: 17 · 2013: 1 · 2012: 1
- FWCI
- 11.30
- Type
- journal article
- Language
- en
- Update notices
- new_version (2022-01-10)
- Open access
- bronze
- doi.org
- Locations
- Cochrane Database of Systematic Reviews (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- University of Twente Research Information (publishedVersion, other-oa)
- Radboud Repository (Radboud University) (submittedVersion)
- University of Twente Research Information (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Keywords
- chronic obstructive pulmonary disease, self-management interventions, health-related quality of life, hospitalization, health care utilization, St George's Respiratory Questionnaire, COPD exacerbations, patient education, disease self-management
- MeSH terms
- Health Status, Hospitalization, Humans, Patient Compliance, Patient Education as Topic, Quality of Life, Self Care, Program Evaluation, Randomized Controlled Trials as Topic, Outcome Assessment, Health Care, Pulmonary Disease, Chronic Obstructive
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