Evidence map›Paper›PMID 27574418›Full record

Trial reportInternational journal of chronic obstructive pulmonary disease2016

Efficacy of a self-management plan in exacerbations for patients with advanced COPD.

Juan Miguel Sánchez-Nieto, Rubén Andújar-Espinosa, Roberto Bernabeu-Mora, Chunshao Hu, Beatriz Gálvez-Martínez, Andrés Carrillo-Alcaraz, Carlos Federico Álvarez-Miranda, Olga Meca-Birlanga, Eva Abad-Corpa

Abstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in International journal of chronic obstructive pulmonary disease, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing 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

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

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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

9 authors.

Juan Miguel Sánchez-NietoDivision of Pneumology, Hospital Morales Meseguer; University of Murcia.
Rubén Andújar-EspinosaDivision of Pneumology, Hospital Arrixaca, Murcia.
Roberto Bernabeu-MoraDivision of Pneumology, Hospital Morales Meseguer; University of Murcia.
Chunshao HuDivision of Pneumology, Hospital Morales Meseguer.
Beatriz Gálvez-MartínezDivision of Pneumology, Hospital Morales Meseguer.
Andrés Carrillo-AlcarazDivision of Pneumology, Hospital Morales Meseguer.
Carlos Federico Álvarez-MirandaDivision of Pneumology, Hospital Arrixaca, Murcia.
Olga Meca-BirlangaDivision of Pneumology, Hospital Morales Meseguer.
Eva Abad-CorpaDepartment of Professional Development Unit, Murcia, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSelf-management interventions improve different outcome variables in various chronic diseases. Their role in COPD has not been clearly established. We assessed the efficacy of an intervention called the self-management program on the need for hospital care due to disease exacerbation in patients with advanced COPD.

methodsMulticenter, randomized study in two hospitals with follow-up of 1 year. All the patients had severe or very severe COPD, and had gone to either an accident and emergency (A&E) department or had been admitted to a hospital at least once in the previous year due to exacerbation of COPD. The intervention consisted of a group education session on the main characteristics of the disease, an individual training session on inhalation techniques, at the start and during the 3rd month, and a written action plan containing instructions for physical activity and treatment for stable phases and exacerbations. We determined the combined number of COPD-related hospitalizations and emergency visits per patient per year. Secondary endpoints were number of patients with visits to A&E and the number of patients hospitalized because of exacerbations, use of antibiotics and corticosteroids, length of hospital stay, and all-cause mortality.

resultsAfter 1 year, the rate of COPD exacerbations with visits to A&E or hospitalization had decreased from 1.37 to 0.89 (P=0.04) and the number of exacerbations dropped from 52 to 42 in the group of patients who received the intervention. The numbers of patients hospitalized, at 19 (40.4%) versus 20 (52.6%) (P=0.26), and those who went to A&E, at 9 (19.1%) versus 14 (36.8%) (P=0.06), due to exacerbation of COPD were also lower in this group. Intake of antibiotics was higher in the intervention group, whereas use of glucocorticoids was slightly lower, though there were no significant differences (P=0.30). There were also no differences between groups in the length of hospital stay (P=0.154) or overall mortality (P=0.191).

conclusionThe implementation of a self-management program for patients with advanced COPD reduced exacerbations that required hospital care.

Indexed as

Administration, InhalationAgedAnti-Bacterial AgentsBronchodilator AgentsDisease ProgressionEmergency Service, HospitalExerciseFemaleHealth Knowledge, Attitudes, PracticeHospitalsHumansKaplan-Meier EstimateLength of StayMaleMiddle AgedNebulizers and VaporizersAnti-Bacterial AgentsBronchodilator AgentsCOPDself-managementsevere exacerbations

Identifiers

PMID27574418
PMCPMC4994798

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Registered trials

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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.