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Nurse-Led/Involved Home-Based Interventions for Older Adults With Chronic Obstructive Pulmonary Disease (COPD): A
Lucillie Silahis Sturm1, Sarah Yeun-Sim Jeong2, Michelle Giles3
1Planned Care for Better Health, Community and Aged Care Services, Hunter New England Local Health District, Adamstown, New South Wales, Australia.
Aims:
To determine the effectiveness of nurse-led/involved home-based interventions for older people with COPD and to explore the experiences of older people and nurses with the interventions.
Design:
A mixed-methods systematic review following the JBI methodology for mixed-methods systematic reviews.
Data Sources:
The search included relevant and peer-reviewed studies published from January 2010 to December 2023 in CINAHL, MEDLINE, Cochrane Central Register of Controlled Trials, PsycINFO, EMBASE, JBI, EMCARE and ProQuest.
Review Methods:
English-language reports of nurse-led/involved home-based interventions for people with COPD were included based on authors' consensus. Three reviewers performed independent quality appraisal using JBI tools. A convergent segregated approach was used for data synthesis and integration.
Results:
Seven interventions were identified in two mixed-methods, two qualitative, two quasi-experimental studies, and one secondary analysis from a randomised control trial. The effectiveness of the interventions was measured with various outcomes and was effective to some extent, with reduced hospitalisation, hospitalisation days, hospitalisation cost and all-paid claims. However, the outcomes were not statistically significant, and the effectiveness was inconclusive. While patients appreciated support and resources, some perceived them as a double-edged sword.
Conclusions:
Patients preferred more holistic interventions over extended periods. The inconclusive findings and limitations warrant further research with larger sample sizes and comparable measurement tools and outcomes.
Impact:
This is the first mixed-methods systematic review on the effectiveness of home interventions for people with COPD with a clear definition of 'nurse-led'. Nurses felt highly valued by patients and other health professionals; however, they reported a lack of support from management. The lack of interventions led by nurses challenges them to lead, deliver and evaluate what matters to people with COPD.
Reporting Method:
This systematic review was reported in accordance with the Referred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.
Patient Or Public Contribution:
Not applicable.
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Primary Symptoms of COPD:
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Medical History
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Smoking Cessation
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Assessment