title: The effects of chronic obstructive pulmonary disease self-management interventions on improvement of quality of life in COPD patients: A meta-analysis.
abstract: This article aimed to analyse the outcome of self-management randomised control trials and their impact upon chronic obstructive pulmonary disease patients' health outcomes using meta-analysis approach. PubMed, Scopus, CINAHL, Web of Science databases and Cochrane Library, were searched for articles between 1990 and December 2015 by two researchers. Self-management programs significantly improved patients' quality of life across all domains of the St George Respiratory Questionnaire (SGRQ) (activity -2.21 (95% CI: -3.61 to -0.80), p = 0.002; impact -3.30 (95% CI: -5.28 to -1.32), p = 0.001; symptoms -3.12 (95% CI: -4.94 to -1.03), p = 0.001; total -3.32 (95% CI: -4.60 to -2.04), p < 0.001), the six-minute walk test (-30.50 (95% CI: 3.32 to 57.68), p = 0.028), and across three domains of the chronic obstructive pulmonary disease self-efficacy scale (negative effect -1.22 (95% CI: -2.31 to -0.14), p = 0.027; physical exertion -1.27 (95% CI: -2.52 to -0.02), p = 0.047; behavioural risk factors -0.58 (95% CI: -0.99 to -0.16), p = 0.007). Subgroup analyses revealed that chronic obstructive pulmonary disease education (p < 0.01) was the strongest component with improvements on all aspects of the SGRQ and the six-minute walk test. Providing an exacerbation action plan significantly improved SGRQ activity and impact scores whilst exercise information had a positive effect on activity and symptom scores (p < 0.05). Interventions with a duration of less than five weeks (p < 0.05) significantly improved symptom and activity scores, in addition to the number of patient hospital admissions. Thus, self-management interventions are effective at improving the health outcomes of chronic obstructive pulmonary disease patients, especially when disease education is provided.
authors.affiliation: Menzies Health Institute Queensland and School of Medicine, Griffith University, Australia. Electronic address: danielle.cannon@griffithuni.edu.au.
authors.forename: Danielle
authors.initials: D
authors.lastname: Cannon
authors.affiliation: Griffith Health Institute, Griffith University, Australia. Electronic address: n.buys@griffith.edu.au.
authors.forename: Nicholas
authors.initials: N
authors.lastname: Buys
authors.affiliation: Department of Respiratory Medicine, Gold Coast University Hospital and School of Medicine, Griffith University, Australia. Electronic address: bajeekrishna.sriram@health.qld.gov.au.
authors.forename: Krishna Bajee
authors.initials: KB
authors.lastname: Sriram
authors.affiliation: General Medicine Department, Gold Coast University Hospital, Australia. Electronic address: siddharth.sharma@health.qld.gov.au.
authors.forename: Siddharth
authors.initials: S
authors.lastname: Sharma
authors.affiliation: School of Allied Health Sciences, Griffith University, Australia. Electronic address: n.morris@griffith.edu.au.
authors.forename: Norman
authors.initials: N
authors.lastname: Morris
authors.affiliation: Menzies Health Institute Queensland and School of Medicine, Griffith University, Australia. Electronic address: j.sun@griffith.edu.au.
authors.forename: Jing
authors.initials: J
authors.lastname: Sun
mesh_terms: D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D010353:Patient Education as Topic; D029424:Pulmonary Disease, Chronic Obstructive / Q000534:rehabilitation*; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D020377:Self Efficacy; D000073278:Self-Management / Q000379:methods*; D012720:Severity of Illness Index