| Title |
Do self-management interventions in COPD patients work and which patients benefit most? An individual patient data meta-analysis
|
|---|---|
| Published in |
International Journal of Chronic Obstructive Pulmonary Disease, August 2016
|
| DOI | 10.2147/copd.s107884 |
| Pubmed ID | |
| Authors |
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, Frode Gallefoss, Judith Garcia-Aymerich, Suzanne M Lloyd, Evelyn M Monninkhof, Huong Q Nguyen, Job van der Palen, Kathryn L Rice, Maria Sedeno, Stephanie JC Taylor, Thierry Troosters, Nicholas A Zwar, Arno W Hoes, Marieke J Schuurmans |
| Abstract |
Self-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. Randomized 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. Fourteen 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. Self-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. |
X Demographics
The data shown below were collected from the profiles of 15 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 4 | 27% |
| Argentina | 1 | 7% |
| Japan | 1 | 7% |
| Canada | 1 | 7% |
| Spain | 1 | 7% |
| Netherlands | 1 | 7% |
| United States | 1 | 7% |
| Unknown | 5 | 33% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 6 | 40% |
| Practitioners (doctors, other healthcare professionals) | 6 | 40% |
| Scientists | 2 | 13% |
| Science communicators (journalists, bloggers, editors) | 1 | 7% |
Mendeley readers
The data shown below were compiled from readership statistics for 151 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | <1% |
| Unknown | 150 | 99% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 24 | 16% |
| Researcher | 16 | 11% |
| Student > Ph. D. Student | 16 | 11% |
| Student > Bachelor | 12 | 8% |
| Student > Doctoral Student | 10 | 7% |
| Other | 26 | 17% |
| Unknown | 47 | 31% |
| Readers by discipline | Count | As % |
|---|---|---|
| Nursing and Health Professions | 34 | 23% |
| Medicine and Dentistry | 25 | 17% |
| Psychology | 8 | 5% |
| Social Sciences | 7 | 5% |
| Biochemistry, Genetics and Molecular Biology | 4 | 3% |
| Other | 16 | 11% |
| Unknown | 57 | 38% |
Attention Score in Context
This research output has an Altmetric Attention Score of 24. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 24 February 2024.
All research outputs
#1,602,092
of 25,373,627 outputs
Outputs from International Journal of Chronic Obstructive Pulmonary Disease
#104
of 2,577 outputs
Outputs of similar age
#29,905
of 381,036 outputs
Outputs of similar age from International Journal of Chronic Obstructive Pulmonary Disease
#5
of 102 outputs
Altmetric has tracked 25,373,627 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 93rd percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,577 research outputs from this source. They typically receive a little more attention than average, with a mean Attention Score of 6.5. This one has done particularly well, scoring higher than 95% of its peers.
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We're also able to compare this research output to 102 others from the same source and published within six weeks on either side of this one. This one has done particularly well, scoring higher than 95% of its contemporaries.