Mortality of patients with COPD participating in chronic disease management programmes: a happy end?
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.
Healthcare Evaluation Unit, Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland.
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I
Peytremann-Bridevaux
Healthcare Evaluation Unit, Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland.
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P
Taffe
Healthcare Evaluation Unit, Institute of Social and Preventive Medicine, Lausanne University Hospital, Lausanne, Switzerland.
B
B
Burnand
Centre Hospitalier du Valais Romand, Sion, Switzerland Division of Pulmonary Medicine, Geneva University Hospital, Geneva, Switzerland.
P O
PO
Bridevaux
Institute of Social and Preventive Medicine, University of Zurich, Zurich, Switzerland.
M A
MA
Puhan
D006801:Humans; D019468:Disease Management; D029424:Pulmonary Disease, Chronic Obstructive / Q000401:mortality / Q000628:therapy; D016032:Randomized Controlled Trials as Topic
COPD epidemiology