Using a Taxonomy to Systematically Identify and Describe Self-Management Interventions Components in Randomized...

Area of Science:

• Pulmonary Medicine
• Health Services Research
• Behavioral Science

Background:

• Self-management interventions (SMIs) show promise for improving outcomes in Chronic Obstructive Pulmonary Disease (COPD).
• Accurate comparisons of SMI effectiveness are hindered by a lack of clarity and detail in intervention content.
• Systematic description of intervention components is needed to advance COPD self-management research.

Purpose of the Study:

• To systematically describe intervention components and characteristics in randomized controlled trials (RCTs) for COPD self-management.
• To identify insufficiently incorporated or reported components using the COMPAR-EU taxonomy.
• To highlight areas for improvement in the design and reporting of COPD SMIs.

Main Methods:

• A systematic review identified 235 RCTs published between 2010 and 2018.
• The COMPAR-EU taxonomy, comprising 132 components across four domains, was used for coding intervention content.
• Risk of bias was assessed alongside intervention component analysis.

Main Results:

• Interventions frequently focused on physical activity, breathing exercises, self-monitoring, and medication use.
• Education, skills training, self-monitoring, and goal setting were common support techniques.
• Emotional support, problem-solving, and shared decision-making were less frequently reported. Many components were poorly incorporated or described, with limited tailoring and consideration of patient-important outcomes.

Conclusions:

• Significant improvements are needed in both the design and reporting of SMIs for COPD.
• The COMPAR-EU taxonomy can enhance reporting consistency and inform replication efforts.
• Prospective use of the taxonomy will aid in building a cumulative science of effective COPD SMIs.