title: Self-management of health care behaviors for COPD: a systematic review and meta-analysis.
abstract: OBJECTIVE
  This systematic review aimed to identify the most effective components of interventions to facilitate self-management of health care behaviors for patients with COPD. PROSPERO registration number CRD42011001588.
  
  
  METHODS
  We used standard review methods with a systematic search to May 2012 for randomized controlled trials of self-management interventions reporting hospital admissions or health-related quality of life (HRQoL). Mean differences (MD), hazard ratios, and 95% confidence intervals (CIs) were calculated and pooled using random-effects meta-analyses. Effects among different subgroups of interventions were explored including single/multiple components and multicomponent interventions with/without exercise.
  
  
  RESULTS
  One hundred and seventy-three randomized controlled trials were identified. Self-management interventions had a minimal effect on hospital admission rates. Multicomponent interventions improved HRQoL (studies with follow-up >6 months St George's Respiratory Questionnaire (MD 2.40, 95% CI 0.75-4.04, I (2) 57.9). Exercise was an effective individual component (St George's Respiratory Questionnaire at 3 months MD 4.87, 95% CI 3.96-5.79, I (2) 0%).
  
  
  CONCLUSIONS
  While many self-management interventions increased HRQoL, little effect was seen on hospital admissions. More trials should report admissions and follow-up participants beyond the end of the intervention.
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Kate
authors.initials: K
authors.lastname: Jolly
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Saimma
authors.initials: S
authors.lastname: Majothi
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Alice J
authors.initials: AJ
authors.lastname: Sitch
authors.affiliation: School of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Nicola R
authors.initials: NR
authors.lastname: Heneghan
authors.affiliation: Research Institute of Primary Care and Health Sciences, Keele University, Keele, Staffordshire.
authors.forename: Richard D
authors.initials: RD
authors.lastname: Riley
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: David J
authors.initials: DJ
authors.lastname: Moore
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Elizabeth J
authors.initials: EJ
authors.lastname: Bates
authors.affiliation: Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
authors.forename: Alice M
authors.initials: AM
authors.lastname: Turner
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Bayliss
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Malcolm J
authors.initials: MJ
authors.lastname: Price
authors.affiliation: Centre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK.
authors.forename: Sally J
authors.initials: SJ
authors.lastname: Singh
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Peymane
authors.initials: P
authors.lastname: Adab
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: David A
authors.initials: DA
authors.lastname: Fitzmaurice
authors.affiliation: Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK.
authors.forename: Rachel E
authors.initials: RE
authors.lastname: Jordan
mesh_terms: D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data; D029424:Pulmonary Disease, Chronic Obstructive / Q000175:diagnosis / Q000523:psychology / Q000628:therapy; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D012648:Self Care / Q000379:methods / Q000523:psychology / Q000706:statistics & numerical data
keywords: COPD; meta-analysis; self-management; systematic review