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Self-management education for chronic obstructive pulmonary disease.
E M Monninkhof1, P D L P M van der Valk, J van der Palen
1Department of Respiratory Medicine, Medisch Spectrum Twente, Haaksbergerstraat 55, Enschede, Netherlands. emonninkhof@introweb.nl
The Cochrane Database of Systematic Reviews
|January 22, 2003
Summary
Self-management education programs for Chronic Obstructive Pulmonary Disease (COPD) showed no significant impact on hospital admissions or lung function. While reducing rescue medication use, these programs did not conclusively improve overall health-related quality of life.
Area of Science:
- Pulmonary Medicine
- Health Services Research
Background:
- Self-management programs are effective for asthma but their value in Chronic Obstructive Pulmonary Disease (COPD) is unclear.
- COPD self-management education aims to improve patient outcomes and healthcare utilization.
Purpose of the Study:
- To assess the efficacy of COPD self-management and education programs on health outcomes and healthcare service utilization.
Main Methods:
- Systematic review of controlled trials (randomised and non-randomised) of self-management education in COPD patients.
- Searched multiple databases and contacted researchers for relevant studies published up to October 2001.
- Two independent reviewers assessed trial quality and extracted data.
Main Results:
- Included 12 articles from 9 trials; 8 were randomised-controlled trials.
- Self-management education did not significantly affect hospital admissions, emergency room visits, work absence, or lung function.
- Health-related quality of life (HRQoL) results were inconclusive, with some improvement in the activity component but heterogeneity between studies. Reduced rescue medication use but increased oral steroid and antibiotic use observed.
Conclusions:
- Available data are insufficient to recommend COPD self-management programs.
- Further research requires well-designed randomised controlled trials with standardized, COPD-specific outcomes and long follow-up periods.
- Focus on behavioral change and standardized outcome measures is crucial for future research.