The development and evaluation of a self-management program for cystic fibrosis
Abstract
Cystic fibrosis (CF) is a major health concern with respect to morbidity and mortality. A self-management program was developed and evaluated to determine how such an approach might reduce the impact of CF on patients and their families. Despite constraints imposed by the context within which the investigation was conducted, positive findings were obtained. These results indicated that children who received self-management training showed significant improvement in weight gain, and aerosol and chest physiotherapy treatments. The conclusion was that self-management procedures should be considered as a major approach to take for improving the health and quality of life of CF patients and their families.
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Most included trials had small sample sizes; seven trials had fewer than 100 participants and many stated they were underpowered.
“Most included trials had small sample sizes; seven trials had fewer than 100 participants and many stated they were underpowered (Cottrell 1996;Downs 2006;Gur 2016;Hind 2017;Knudsen 2016;Quinn 2004;Shakkottai 2017).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
Some included trials reported relatively large numbers of participants who had declined to take part, while others did not report this information at all.
“Some of our included trials reported relatively large numbers of participants who had declined to take part (Cottrell 1996; Knudsen 2016; Wildman 2022); whilst others did not report this information at all.”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
In two trials, the duration and intensity of the intervention was unclear.
“In two trials, the duration and intensity of the intervention was unclear; either because no details were provided on the scheduling of the two six-hour training sessions (Cottrell 1996), or because it was unclear if the information provided (one clinic session and eight phone sessions over six months) was in reference to the intervention or active comparator arm, or both (Riekert 2013).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
10 trials (69 references) were included in this review.
“This leaves 10 trials (69 references) for inclusion in this review (Cottrell 1996;Downs 2006;Gur 2016;Hind 2017;Knudsen 2016;Quinn 2004;Quittner 2019;Riekert 2013;Shakkottai 2017;Wildman 2022).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
Nine of these 10 trials could also be included in limited quantitative syntheses (meta-analyses).
“Nine of these 10 trials could also be included in limited quantitative syntheses (meta-analyses) (Cottrell 1996;Downs 2006;Gur 2016;Hind 2017;Knudsen 2016;Quinn 2004;Quittner 2019;Shakkottai 2017;Wildman 2022).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
The generation of allocation sequence was unclear in three trials (Cottrell 1996; Riekert 2013; Shakkottai 2017) and high in one trial (Gur 2016).
“The generation of allocation sequence was unclear in three trials (Cottrell 1996;Riekert 2013;Shakkottai 2017) and high in one trial (Gur 2016)”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
The nine trials provided no description of the 'usual care' comparator, which precluded BCT coding of the control groups.
“The nine trials provided no description of the 'usual care' comparator, which precluded BCT coding of the control groups (Cottrell 1996;Downs 2006;Gur 2016;Hind 2017;Knudsen 2016;Quinn 2004;Quittner 2019;Shakkottai 2017;Wildman 2022).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
Nine trials included QoL as an outcome using a range of measures (Cottrell 1996; Gur 2016; Hind 2017; Knudsen 2016; Quinn 2004; Quittner 2019; Riekert 2013; Shakkottai 2017; Wildman 2022).
“Nine trials included QoL as an outcome using a range of measures (Cottrell 1996;Gur 2016;Hind 2017;Knudsen 2016;Quinn 2004;Quittner 2019;Riekert 2013;Shakkottai 2017;Wildman 2022).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
One trial (Cottrell 1996) assessed QoL using the Quality of Wellbeing scale (Kaplan 1989).
“One trial (Cottrell 1996) assessed QoL using the Quality of Wellbeing scale (Kaplan 1989).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
Allocation concealment was at high risk of bias in two trials (Downs 2006; Gur 2016) and unclear in five trials (Cottrell 1996; Knudsen 2016; Quittner 2019; Riekert 2013; Shakkottai 2017).
“allocation concealment was at high risk of bias in two trials (Downs 2006;Gur 2016) and unclear in five trials (Cottrell 1996;Knudsen 2016;Quittner 2019;Riekert 2013;Shakkottai 2017).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
Blinding of outcome assessors was unclear in six trials (Cottrell 1996; Downs 2006; Knudsen 2016; Quinn 2004; Quittner 2019; Riekert 2013) and high risk in four trials (Gur 2016; Hind 2017; Shakkottai 2017; Wildman 2022).
“Blinding of outcome assessors was unclear in six trials (Cottrell 1996;Downs 2006;Knudsen 2016;Quinn 2004;Quittner 2019;Riekert 2013) and high risk in four trials (Gur 2016;Hind 2017;Shakkottai 2017;Wildman 2022).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
Nine trials (approximately 1514 participants) contributed data to the comparison of psychological interventions versus usual care.
“Nine trials (approximately 1514 participants) contributed data to the comparison of psychological interventions versus usual care (Cottrell 1996;Downs 2006;Gur 2016;Hind 2017;Knudsen 2016;Quinn 2004;Quittner 2019;Shakkottai 2017;Wildman 2022).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
Three remaining trials were described as randomised, but no details of the actual randomisation process were given; they were judged to have an unclear risk of bias.
“The three remaining trials were described as randomised, but no details of the actual randomisation process were given; therefore, we judged these trials to have an unclear risk of bias (Cottrell 1996;Riekert 2013;Shakkottai 2017).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
In the Cottrell 1996 trial, the mean (SD) baseline weight was 89.15 (29.29) lb in the intervention group and 101.4 (32.17) lb in the control group, indicating a clinically important baseline imbalance for CF.
“As highlighted in a previous Cochrane Review (Savage 2014), in one trial, the mean (SD) baseline weight measurement for participants in the intervention group was 89.15 (29.29) lb and for participants in the control group was 101.4 (32.17) lb, which, for CF, indicates a clinically important baseline imbalance (Cottrell 1996).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
The 10 trials differed in the outcomes and the time points assessed, ranging from six to eight weeks post-intervention to 23 months post-intervention.
“The 10 trials differed in the outcomes and the time points assessed (ranging from six to eight weeks post-intervention (Cottrell 1996) to 23 months postintervention (Knudsen 2016)).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
Two trials reported baseline imbalances which were unadjusted in the results (Cottrell 1996; Riekert 2013).
“Two trials reported baseline imbalances (which were unadjusted in the results) (Cottrell 1996;Riekert 2013).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
The review authors judged three trials to have a high risk of bias from other sources (Cottrell 1996; Quittner 2019; Riekert 2013).
“We judged three trials to have a high risk of bias from other sources (Cottrell 1996;Quittner 2019;Riekert 2013).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
The remaining nine trials compared a psychological intervention to a usual care or 'treatment as usual' control group.
“The remaining nine trials compared a psychological intervention (as described below) to a usual care or 'treatment as usual' control group (Cottrell 1996;Downs 2006;Gur 2016;Hind 2017;Knudsen 2016;Quinn 2004;Quittner 2019;Shakkottai 2017;Wildman 2022).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
The review authors were unable to access protocols to assess selective reporting for three trials (Cottrell 1996; Downs 2006; Quinn 2004).
“We were unable to access protocols to assess selective reporting for three trials (Cottrell 1996;Downs 2006;Quinn 2004).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
The review authors judged six trials to have an unclear risk of bias for selective reporting (Cottrell 1996; Downs 2006; Gur 2016; Quinn 2004; Riekert 2013; Shakkottai 2017).
“We judged six trials to have an unclear risk of bias for selective reporting (Cottrell 1996;Downs 2006;Gur 2016;Quinn 2004;Riekert 2013;Shakkottai 2017).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
The trial authors highlighted a possible ceiling effect, with participants scoring 0.7 or higher at baseline (on a scale of 0 to 1, where 0 is 'death' and 1 is 'perfect health'), suggesting that participants were already experiencing a relatively high QoL pre-intervention (Cottrell 1996).
“The trial authors highlighted a possible ceiling effect, with participants scoring 0.7 or higher at baseline (on a scale of 0 to 1, where 0 is 'death' and 1 is 'perfect health'), suggesting that participants were already experiencing a relatively high QoL pre-intervention (Cottrell 1996).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
A range of healthcare professionals delivered the interventions, including psychologists or registered nurses, or a trainee clinical psychologist.
“A range of healthcare professionals delivered the interventions, including psychologists or registered nurses (Cottrell 1996), or a trainee clinical psychologist (Quinn 2004).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
Four trials were judged high risk of bias for incomplete outcome data.
“We judged four trials to have a high risk of bias for incomplete outcome data (Cottrell 1996;Downs 2006;Knudsen 2016;Quittner 2019).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
Five trials (Cottrell 1996, Knudsen 2016, Quittner 2019, Riekert 2013, Shakkottai 2017) had an unclear risk of bias from allocation concealment because they did not report on allocation concealment.
“We judged five trials to have an unclear risk of bias as they did not report on allocation concealment (Cottrell 1996;Knudsen 2016;Quittner 2019;Riekert 2013;Shakkottai 2017).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
Four trials measured adherence using subjective measures (Cottrell 1996, Downs 2006, Gur 2016, Knudsen 2016).
“Four trials measured adherence using subjective measures (Cottrell 1996;Downs 2006;Gur 2016;Knudsen 2016).”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
Cottrell 1996 intervention included problem solving, instruction on how to perform the behaviour, and credible source.
“Cottrell 1996 • 1.2 Problem solving • 4.1 Instruction on how to perform the behaviour • 9.1 Credible source”
From Psychological interventions for improving adherence to inhaled therapies in people with cystic fibrosis (2023) · cites this paper as Cottrell 1996
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“A total of 13 RCTs were excluded as the intervention was not appropriate for inclusion (Alpern 2011; Andrade 2013; Bryon 2000; Christian 2006; Cottrell 1996; Cruz 2007; Davis 2004; DeLambo 2004; Downs 2006; Farrell 2014; Huang 2014; Blackwell 2015; Stabler 1981).”
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“Perhaps surprisingly (for studies related to SCS of diet and the gut), few included patient-reported outcomes, such as control of symptoms or quality of life (the exceptions being Christie et al., 2016; Cottrell et al., 1996; Fiallo-Scharer et al., 2019; Price et al., 2016), and only one study focused on GI-related qu…”
BackgroundMethodInfluential
- Authors
- COTTRELL, C. K., YOUNG, G. A., CREER, T. L., HOLROYD, K. A., & KOTSES, H.
- Venue
- Pediatric Asthma, Allergy & Immunology
- Publisher
- SAGE Publications
- Published
- 1996-01
- Volume
- 10
- Issue
- 3
- Pages
- 109-118
- ISSN
- 0883-1874 (ISSN-L)
- 1557-7767
- OpenAlex
- W1993269239
- Cited by
- 10
- References
- 17
- Citations by year
- 2023: 1 · 2021: 1 · 2019: 1 · 2018: 1 · 2017: 1 · 2016: 1 · 2014: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Pediatric Asthma Allergy & Immunology (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cystic Fibrosis Research Advances
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Keywords
- cystic fibrosis, self-management program, patient education, children, weight gain, inhalation therapy, chest physiotherapy, quality of life, family caregivers
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