title: Towards tailoring of self-management for patients with chronic heart failure or chronic obstructive pulmonary disease: a protocol for an individual patient data meta-analysis.
abstract: BACKGROUND
  Self-management interventions in patients with chronic conditions have received increasing attention over the past few years, yet the meta-analyses encountered considerable heterogeneity in results. This suggests that the effectiveness of self-management interventions must be assessed in the context of which components are responsible for eliciting the effect and in which subgroups of patients the intervention works best. The aim of the present study is to identify condition-transcending determinants of success of self-management interventions in two parallel individual patient data meta-analyses of self-management trials in patients with congestive heart failure (CHF) and in patients with chronic obstructive pulmonary disease (COPD).
  
  
  METHODS
  Investigators of 53 randomised trials (32 in CHF and 21 in COPD) will be requested to share their de-identified individual patient data. Data will be analysed using random effects models, taking clustering within studies into account. Effect modification by age, sex, disease severity, symptom status, comorbid conditions and level of education will be assessed. Sensitivity analyses will be conducted to assess the robustness of the findings.
  
  
  BACKGROUND
  The de-identified individual patient data are used only for the purpose for which they were originally collected and for which ethical approval has been obtained by the original investigators. Knowledge on the effective ingredients of self-management programmes and identification of subgroups of patients in which those interventions are most effective will guide the development of evidence-based personalised self-management interventions for patients with CHF and COPD as well as with other chronic diseases.
  CRD42013004698.
authors.affiliation: Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Nini H
authors.initials: NH
authors.lastname: Jonkman
authors.affiliation: Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Heleen
authors.initials: H
authors.lastname: Westland
authors.affiliation: Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Jaap C A
authors.initials: JC
authors.lastname: Trappenburg
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Rolf H H
authors.initials: RH
authors.lastname: Groenwold
authors.affiliation: Department of Respiratory Medicine, Repatriation General Hospital, Daw Park, South Australia, Australia.
authors.forename: Tanja W
authors.initials: TW
authors.lastname: Effing-Tijdhof
authors.affiliation: Department of Rehabilitation Sciences, Catholic University of Leuven, Leuven, Belgium.
authors.forename: Thierry
authors.initials: T
authors.lastname: Troosters
authors.affiliation: Department of Research Methodology, Measurement and Data Analysis, University of Twente, Enschede, The Netherlands.
authors.forename: Job
authors.initials: J
authors.lastname: van der Palen
authors.affiliation: Respiratory Epidemiology Unit, McGill University, Montreal, Quebec, Canada.
authors.forename: Jean
authors.initials: J
authors.lastname: Bourbeau
authors.affiliation: Department of Social and Welfare Studies, Linköping University, Linköping, Sweden.
authors.forename: Tiny
authors.initials: T
authors.lastname: Jaarsma
authors.affiliation: Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Arno W
authors.initials: AW
authors.lastname: Hoes
authors.affiliation: Department of Rehabilitation, Nursing Science and Sports, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Marieke J
authors.initials: MJ
authors.lastname: Schuurmans
mesh_terms: D006801:Humans; D002985:Clinical Protocols; D006333:Heart Failure / Q000150:complications / Q000628:therapy; D015201:Meta-Analysis as Topic; D017063:Outcome Assessment, Health Care; D010349:Patient Compliance; D015397:Program Evaluation; D029424:Pulmonary Disease, Chronic Obstructive / Q000150:complications / Q000628:therapy; D012648:Self Care / Q000379:methods
keywords: COPD; Chronic Disease; Chronic Heart Failure; Individual Patient Data Meta-Analysis; Self-Management