Evidence map›Paper›PMID 27621612›Full record

SynthesisInternational journal of chronic obstructive pulmonary disease2016

Do self-management interventions in COPD patients work and which patients benefit most? An individual patient data meta-analysis.

Nini H Jonkman, Heleen Westland, Jaap Ca Trappenburg, Rolf Hh Groenwold, Erik Wma Bischoff, Jean Bourbeau, Christine E Bucknall, David Coultas, Tanja W Effing, Michael J Epton and 13 more

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

Synthesis 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 31 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 3 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, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Trial
  5. Trial
  6. Trial
  7. Effects of a COPD self-management support intervention: a randomized controlled trial.International journal of chronic obstructive pulmonary disease
    Trial
  8. Article
  9. Review
  10. Review
  11. Personalizing Self-Management Interventions in COPD - Looking Beyond One-Size-Fits-All.International journal of chronic obstructive pulmonary disease · 2025
    Article
  12. Article
  13. Article
  14. Review
  15. Article
  16. Article
  17. Article
  18. Article
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  20. Observational
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

23 authors.

Nini H JonkmanDepartment of Rehabilitation, Nursing Science and Sports.
Heleen WestlandDepartment of Rehabilitation, Nursing Science and Sports.
Jaap Ca TrappenburgDepartment of Rehabilitation, Nursing Science and Sports.
Rolf Hh GroenwoldJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht.
Erik Wma BischoffDepartment of Primary and Community Care, Radboud University Medical Center, Nijmegen, the Netherlands.
Jean BourbeauRespiratory Epidemiology and Clinical Research Unit, Department of Medicine, McGill University Health Center, McGill University, Montreal, QC, Canada.
Christine E BucknallDepartment of Respiratory Medicine, Glasgow Royal Infirmary, Glasgow, UK.
David CoultasVeterans Administration Portland Health Care System and Oregon Health & Science University, Portland, OR, USA.
Tanja W EffingDepartment of Respiratory Medicine, Repatriation General Hospital, Adelaide, SA, Australia.
Michael J EptonCanterbury District Health Board, Respiratory Services, Christchurch Hospital, Christchurch, New Zealand.
Frode GallefossDepartment of Pulmonary Medicine, Sorlandet Hospital, Kristiansand, Norway.
Judith Garcia-AymerichCentre for Research in Environmental Epidemiology CREAL; Pompeu Fabra University; CIBER Epidemiología y Salud Pública CIBERESP, Barcelona, Spain.
Suzanne M LloydRobertson Centre for Biostatistics, University of Glasgow, Glasgow, UK.
Evelyn M MonninkhofJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht.
Huong Q NguyenDepartment of Research and Evaluation, Kaiser Permanente Southern California, Pasadena, CA, USA.
Job van der PalenDepartment of Research Methodology, Measurement and Data Analysis, University of Twente; Department of Clinical Epidemiology, Medisch Spectrum Twente, Enschede, the Netherlands.
Kathryn L RiceDivision of Pulmonary, Allergy, Critical Care and Sleep Medicine, Minneapolis Veterans Affairs Health Care Service and University of Minnesota, Minneapolis, MN, USA.
Maria SedenoRespiratory Epidemiology and Clinical Research Unit, Department of Medicine, McGill University Health Center, McGill University, Montreal, QC, Canada.
Stephanie Jc TaylorCentre for Primary Care and Public Health, Queen Mary University of London, London, UK.
Thierry TroostersDepartment of Rehabilitation Sciences, Catholic University of Leuven, Leuven, Belgium.
Nicholas A ZwarSchool of Public Health and Community Medicine, UNSW Australia, Sydney, NSW, Australia.
Arno W HoesJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht.
Marieke J SchuurmansDepartment of Rehabilitation, Nursing Science and Sports.

Funding

Department of Health PB-PG-0906-11172
6 · The paper itself

Abstract

backgroundSelf-management interventions are considered effective in patients with COPD, but trials have shown inconsistent results and it is unknown which patients benefit most. This study aimed to summarize the evidence on effectiveness of self-management interventions and identify subgroups of COPD patients who benefit most.

methodsRandomized trials of self-management interventions between 1985 and 2013 were identified through a systematic literature search. Individual patient data of selected studies were requested from principal investigators and analyzed in an individual patient data meta-analysis using generalized mixed effects models.

resultsFourteen trials representing 3,282 patients were included. Self-management interventions improved health-related quality of life at 12 months (standardized mean difference 0.08, 95% confidence interval [CI] 0.00-0.16) and time to first respiratory-related hospitalization (hazard ratio 0.79, 95% CI 0.66-0.94) and all-cause hospitalization (hazard ratio 0.80, 95% CI 0.69-0.90), but had no effect on mortality. Prespecified subgroup analyses showed that interventions were more effective in males (6-month COPD-related hospitalization: interaction P=0.006), patients with severe lung function (6-month all-cause hospitalization: interaction P=0.016), moderate self-efficacy (12-month COPD-related hospitalization: interaction P=0.036), and high body mass index (6-month COPD-related hospitalization: interaction P=0.028 and 6-month mortality: interaction P=0.026). In none of these subgroups, a consistent effect was shown on all relevant outcomes.

conclusionSelf-management interventions exert positive effects in patients with COPD on respiratory-related and all-cause hospitalizations and modest effects on 12-month health-related quality of life, supporting the implementation of self-management strategies in clinical practice. Benefits seem similar across the subgroups studied and limiting self-management interventions to specific patient subgroups cannot be recommended.

Indexed as

Patient SelectionAgedDisease ProgressionEvidence-Based MedicineFemaleForced Expiratory VolumeHospitalizationHumansLungMaleMiddle AgedOdds RatioPulmonary Disease, Chronic ObstructiveQuality of LifeRandomized Controlled Trials as TopicRecovery of Functionchronic obstructive pulmonary diseaseindividual patient data meta-analysisself-managementsubgroup analysis

Identifiers

PMID27621612
PMCPMC5012618

What OpenQuestion holds

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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.