1. Meta-analysis of self-management education for patients with chronic obstructive pulmonary disease
- Author
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Hurley J, Gerkin RD, Fahy B, and Robbins RA
- Subjects
chronic obstructive pulmonary disease ,education ,emergency room visits ,hospitalizations ,meta-analysis ,mortality ,self-management ,stopping studies early ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 ,Diseases of the respiratory system ,RC705-779 - Abstract
BackgroundChronic obstructive pulmonary disease (COPD) is a common disease frequently associated with high use of health services. Self-management education is a term applied to programs aimed at teaching patients skills that promote the self-efficacy needed to carry out medical regimens specific to control their disease. In COPD, the value of self-management education is not yet clear and a recent trial was terminated early because of excess mortality in the intervention group.ObjectivesThe objective of this meta-analysis was to assess the settings, methods and efficacy of COPD self-management education programs on patient outcomes and healthcare utilization.Selection criteriaRandomized controlled trials of self-management education in patients with COPD were identified. Studies focusing primarily on comprehensive pulmonary rehabilitation (education and exercise) and studies without usual care as a control group were excluded.Search strategyWe searched PubMed (January 1985 to May 2012) as well as other meta-analysis and reviews.Data collection and analysisTwo reviewers (JH and RAR) independently assessed study quality and extracted data. Investigators were contacted for additional information.Main resultsThe reviewers included 3 group comparisons drawn from 12 trials. The studies showed no significant change in mortality, with one study being an outlier compared to the others. However, the meta-analysis revealed a reduction in the probability of hospital admission among patients receiving self-management education compared to those receiving usual care.ConclusionsIt is likely that self-management education is associated with a reduction in hospital admissions with no change in mortality. However, because of heterogeneity in interventions, study populations, follow-up time, and outcome measures, data are still insufficient to formulate clear recommendations regarding the preferred curriculum and delivery method of self-management education programs in COPD.
- Published
- 2012