Late Breaking Abstract - Self-management interventions for patients with COPD – a Cochrane review

Abstract

<b>Aim:</b> In a Cochrane review update, we evaluated the effectiveness and safety of COPD self-management interventions compared to usual care in patients with COPD. We planned subgroup analyses to identify effective characteristics of the interventions. <b>Methods:</b> A literature search identified randomised or cluster-randomised controlled trials from 1995 until January 2020 that pertained to COPD self-management interventions with at least two intervention components, and an iterative process between patient and healthcare provider including goals and feedback. All records were independently assessed by two authors. <b>Results:</b> Of 546 full-text screened records, 27 studies, including 6,008 patients with follow-up between 2.5 and 24 months were included. A statistically significant beneficial effect was found on health-related quality of life (HRQoL) (St. George’s Respiratory Questionnaire total score (MD -2.86 (95% CI -4.87 to -0.85); 2,807 patients; 14 studies). Self-management interventions also led to significant lower respiratory-related hospital admissions (OR 0.75 (95% CI 0.57 to 0.99); 3,292 patients; 15 studies). No effects were observed on respiratory-related and all-cause mortality. Patients also had fewer emergency department visits, less anxiety and depression symptoms, better exercise capacity, but used more oral steroids and antibiotics. <b>Conclusion:</b> COPD self-management interventions are associated with improved HRQoL and lower probability of respiratory-related hospital admissions. The absence of effects on mortality strengthens the view that COPD self-management interventions are safe. We were unable to shed light on effective self-management intervention characteristics.