Effectiveness of chronic obstructive pulmonary disease self-management interventions in primary care settings: a systematic review
Hassan Hosseinzadeh A and Mahmmoud Shnaigat A B
+ Author Affiliations
- Author Affiliations
A School of Health & Society, Building 15, University of Wollongong, Wollongong, NSW 2522, Australia.
B Corresponding author. Email: maks873@uowmail.edu.au
Australian Journal of Primary Health 25(3) 195-204 https://doi.org/10.1071/PY18181
Submitted: 26 November 2018 Accepted: 26 April 2019 Published: 17 June 2019
Journal Compilation © La Trobe University 2019 Open Access CC BY-NC-ND
Abstract
Chronic obstructive pulmonary disease (COPD) is one of the more disabling diseases and the third cause of mortality worldwide. Self-management is considered an effective strategy for controlling and managing COPD. This review aims to summarise the available evidence on the effectiveness of COPD self-management in primary care settings. Social Sciences, Citation Index, MEDLINE, CINAHL, Academic Search Complete and Scopus were searched for randomised controlled trials of COPD self-management in general practice between 2001 and 2018. Ten randomised controlled trials of COPD self-management trials conducted in primary care settings were included in this review. The identified trials have recruited stable patients; a majority having mild to moderate COPD. The trials implemented different types of interventions and measured improvements in knowledge, skills and behaviours of self-management, mental health, self-efficacy and endpoint outcomes such as hospitalisation and quality of life. The findings showed that COPD self-management trials had positive effects on COPD knowledge and improved self-management behaviours such as adherence to medication, physical activities and smoking cessation in some cases; however, the effect of trials on hospitalisation rate, quality of life and healthcare utilisation were not conclusive. There was also not enough evidence to suggest that the trials were efficient in improving self-efficacy, a major driver of self-management behaviours. Primary care COPD self-management trials are efficient in improving surrogate outcomes such as knowledge of and adherence to self-management behaviours; however, such improvements are less likely to be sustainable in the absence of self-efficacy. Future studies should also focus on improving endpoint self-management outcomes like hospitalisation rate and quality of life to benefit both patient and healthcare system.
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