Evidence map›Paper›PMID 25995625›Full record

SynthesisInternational journal of chronic obstructive pulmonary disease2015

Supported self-management for patients with COPD who have recently been discharged from hospital: a systematic review and meta-analysis.

Saimma Majothi, Kate Jolly, Nicola R Heneghan, Malcolm J Price, Richard D Riley, Alice M Turner, Susan E Bayliss, David J Moore, Sally J Singh, Peymané Adab and 2 more

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in International journal of chronic obstructive pulmonary disease, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

31 citing papers in PubMed, 7 syntheses or guidelines pooled it.

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  19. Talking the same language on patient empowerment: Development and content validation of a taxonomy of self-management interventions for chronic conditions.Health expectations : an international journal of public participation in health care and health policy · 2021
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Saimma MajothiPublic Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, Birmingham, UK.
Kate JollyPublic Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, Birmingham, UK.
Nicola R HeneghanSchool of Sport, Exercise and Rehabilitation Sciences, University of Birmingham, Birmingham, UK.
Malcolm J PricePublic Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, Birmingham, UK.
Richard D RileyResearch Institute of Primary Care and Health Sciences, Keele University, Staffordshire, UK.
Alice M TurnerQueen Elizabeth Hospital Research Laboratories, Birmingham, UK.
Susan E BaylissPublic Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, Birmingham, UK.
David J MoorePublic Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, Birmingham, UK.
Sally J SinghCentre for Exercise and Rehabilitation Science, University Hospitals of Leicester NHS Trust, Glenfield Hospital, Leicester, UK.
Peymané AdabPublic Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, Birmingham, UK.
David A FitzmauricePrimary Care Clinical Sciences, School of Health and Population Sciences, University of Birmingham, Birmingham, UK.
Rachel E JordanPublic Health, Epidemiology and Biostatistics, School of Health and Population Sciences, University of Birmingham, Birmingham, UK.

Funding

Department of Health 10/44/01Department of Health PDF/01/023Department of Health WMCLAHRC-2014-1Medical Research Council MR/K00414X/1
6 · The paper itself

Abstract

purposeAlthough many hospitals promote self-management to chronic obstructive pulmonary disease (COPD) patients post discharge from hospital, the clinical effectiveness of this is unknown. We undertook a systematic review of the evidence as part of a Health Technology Assessment review.

methodsA comprehensive search strategy with no language restrictions was conducted across relevant databases from inception to May 2012. Randomized controlled trials of patients with COPD, recently discharged from hospital after an acute exacerbation and comparing a self-management intervention with control, usual care or other intervention were included. Study selection, data extraction, and risk of bias assessment were undertaken by two reviewers independently.

resultsOf 13,559 citations, 836 full texts were reviewed with nine randomized controlled trials finally included in quantitative syntheses. Interventions were heterogeneous. Five trials assessed highly supported multi-component interventions and four trials were less supported with fewer contacts with health care professionals and mainly home-based interventions. Total sample size was 1,466 (range 33-464 per trial) with length of follow-up 2-12 months. Trials varied in quality; poor patient follow-up and poor reporting was common. No evidence of effect in favor of self-management support was observed for all-cause mortality (pooled hazard ratio =1.07; 95% confidence interval [0.74 to 1.55]; I (2)=0.0%, [n=5 trials]). No clear evidence of effect on all-cause hospital admissions was observed (hazard ratio 0.88 [0.61, 1.27] I (2)=66.0%). Improvements in St George's Respiratory Questionnaire score were seen in favor of self-management interventions (mean difference =3.84 [1.29 to 6.40]; I (2)=14.6%), although patient follow-up rates were low.

conclusionThere is insufficient evidence to support self-management interventions post-discharge. There is a need for good quality primary research to identify effective approaches.

Indexed as

Home Care ServicesPatient DischargeSelf CareHumansLungPatient ReadmissionPulmonary Disease, Chronic ObstructiveQuality of LifeRecovery of FunctionRisk FactorsRisk Reduction BehaviorSurveys and QuestionnairesTime FactorsTreatment Outcomechronic obstructive pulmonary diseasepost-dischargeself-management supportsystematic review

Identifiers

PMID25995625
PMCPMC4425235

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.