Self-management effective for chronic obstructive pulmonary disease

Clinical question: 
Do self-management interventions in chronic obstructive pulmonary disease (COPD) lead to improved health outcomes and/or reduced healthcare utilisation?
Bottom line: 
Self-management interventions in patients with COPD were associated with improved health-related quality of life as measured by the St George’s Respiratory Questionnaire, a reduction in respiratory-related hospital admissions and improvement in dyspnoea as measured by the modified Medical Research Council Scale. Over 1 year of follow-up, the NNT* to prevent respiratory-related hospital admissions ranged from 8 (high baseline risk) to 20 (low baseline risk). No statistically significant differences were found in other outcome parameters (all-cause hospitalisation, mortality, exercise capacity). *NNT = number needed to treat to benefit 1 individual
Caveat: 
It was not possible to pool head-to-head trials because of heterogeneity among interventions, study populations, follow-up time and outcome measures. Hospital-based and rehabilitation centre–based rehabilitation programmes were excluded because self-management often is only a minor part of these very intensive programmes.
Context: 
Self-management interventions help patients with COPD acquire and practise the skills they need to carry out disease-specific medical regimens, guide changes in health behaviour and provide emotional support to enable patients to control their disease.
Review CD#: 
CD002990
PEARLS No: 
446
Date: 
October, 2014
Authored by: 
Brian R McAvoy