Effect of the 5A Model on Clinical Status Indexes of COPD Patients

ObjectiveMany patients with chronic obstructive pulmonary disease (COPD) experience persistent interrelated psychological and physical symptoms despite optimal treatment. Several studies of psychosocial intervention in COPD have been published in recent years. The present study aimed to conduct a quantitative summary of the efficacy of such interventions on psychological and physical outcomes.MethodsTwo independent raters screened PubMed, PsycINFO, Embase, Web of Science, Cochrane Library, and CINAHL for eligible studies. In all, 35 independent, randomized controlled trials with a total of 3,120 patients with COPD were included, assessed for their methodological quality, and subjected to meta-analytic evaluation.ResultsMeta-analyses revealed small, statistically significant effects of psychosocial intervention on combined psychological (Hedges’s g = 0.28; 95%CI: 0.16–0.41) and physical outcomes (g = 0.21; 95%CI: 0.07–0.35) with no indications of publication bias. Supplementary Bayesian meta-analyses provided strong evidence for a non-zero overall effect on psychological outcomes (Bayes factor (BF) = 305) and moderate support for physical outcomes (BF = 6.1). Exploring sources of heterogeneity with meta-regression indicated that older age of patients and longer duration of interventions were associated with smaller effects on psychological outcomes.ConclusionsThe results support psychosocial intervention as an additional, useful tool in multidisciplinary respiratory care with the potential to improve both psychological and physical outcomes. Future studies are recommended to monitor adverse effects, apply blinding of active control conditions, and determine sample sizes with a priori power calculations.RegistrationRegistered with Prospero (www.crd.york.ac.uk/prospero/) prior to initiation of the literature search (Reg. ID: CRD42020170083).

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Effect of the 5A Model on Clinical Status Indexes of COPD Patients

Abstract: Using the 5A model can lead to increased exercise tolerance and decreased dyspnea in COPD patients. Therefore, this self-management program is recommended as an effective way to improve their functional status.

Cited by 5 publications

References 20 publications

Self-management interventions for people with chronic obstructive pulmonary disease

Self-management interventions for people with chronic obstructive pulmonary disease

Integrated disease management interventions for patients with chronic obstructive pulmonary disease

Psychosocial Intervention in Chronic Obstructive Pulmonary Disease: Meta-Analysis of Randomized Controlled Trials

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