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Mortality of patients with COPD participating in chronic disease management programmes: a happy end?
I Peytremann-Bridevaux1, P Taffe1, B Burnand1
1Healthcare Evaluation Unit, Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland.
Background:
Concerns about increased mortality could question the role of COPD chronic disease management (CDM) programmes. We aimed at extending a recent Cochrane review to assess the effects of CDM on mortality in patients with COPD.
Methods:
Mortality data were available for 25 out of 29 trials identified in a COPD integrated care systematic review. Meta-analysis using random-effects models was performed, followed by subgroup analyses according to study length (3-12 months vs >12 months), main intervention component (exercise, self-management, structured follow-up) and use of an action plan.
Results:
The meta-analysis showed no impact of CDM on mortality (pooled OR: 1.00, 95% CI 0.79 to 1.28).
Conclusions:
These results do not suggest that CDM programmes expose patients with COPD to excessive mortality risk.
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