Systematic review of the effects of chronic disease management on quality-of-life in people with chronic obstructive pulmonary disease

Niesink, A.; Trappenburg, Jaap C.A.; Oene, G.H. de Weert-van; Lammers, Jan-Willem; Verheij, Theo; Schrijvers, A. J. P.

doi:10.1016/j.rmed.2007.07.017

Cited by 51 publications

(44 citation statements)

References 34 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nevertheless, no studies reported a deterioration in HRQL and also there seemed to be no relation with the COPD severity of the included population or the setting in which the program was implemented. The latter is in contrast with a previous review of Niesink and colleagues,48 concluding that improved HRQL resulting from COPD disease management is limited to programs that are (at least partly) implemented in primary care.…”

Section: Discussioncontrasting

confidence: 74%

Identifying potentially cost effective chronic care programs for people with COPD

Steuten

Lemmens²,

Nieboer³

et al. 2008

COPD

View full text Add to dashboard Cite

Objective: To review published evidence regarding the cost effectiveness of multi-component COPD programs and to illustrate how potentially cost effective programs can be identifi ed. Methods: Systematic search of Medline and Cochrane databases for evaluations of multicomponent disease management or chronic care programs for adults with COPD, describing process, intermediate, and end results of care. Data were independently extracted by two reviewers and descriptively summarized. Results: Twenty articles describing 17 unique COPD programs were included. There is little evidence for signifi cant improvements in process and intermediate outcomes, except for increased provision of patient self-management education and improved disease-specifi c knowledge. Overall, the COPD programs generate end results equivalent to usual care, but programs containing Ն3 components show lower relative risks for hospitalization. There is limited scope for programs to break-even or save money. Conclusion: Identifying cost effective multi-component COPD programs remains a challenge due to scarce methodologically sound studies that demonstrate signifi cant improvements on process, intermediate and end results of care. Estimations of potential cost effectiveness of specifi c programs illustrated in this paper can, in the absence of 'perfect data', support timely decision-making regarding these programs. Nevertheless, well-designed health economic studies are needed to decrease the current decision uncertainty.

show abstract

Section: Discussioncontrasting

confidence: 74%

Identifying potentially cost effective chronic care programs for people with COPD

Steuten

Lemmens²,

Nieboer³

et al. 2008

COPD

View full text Add to dashboard Cite

show abstract

“…The positive impact of smoking cessation on mortality and morbidity is well established,13 but few studies have showed the relevant impact on HRQoL and readmission. Furthermore, HRQoL had been determined in several intervention studies to achieving management goals in COPD 29,30…”

Section: Discussionmentioning

confidence: 99%

Does the duration of smoking cessation have an impact on hospital admission and health-related quality of life amongst COPD patients?

Hassan¹,

Aziz²,

Hassan³

et al. 2014

COPD

View full text Add to dashboard Cite

BackgroundLack of awareness among ex-smokers on the benefits of sustaining smoking cessation may be the main cause of their smoking relapse. This study explored health-related quality of life (HRQoL) and hospital admission amongst chronic obstructive pulmonary disease (COPD) patients according to the duration of smoking cessation.Materials and methodsThis study recruited COPD patients from a chest clinic who agreed to participate in a medication therapy-adherence program from January to June 2013. They were interviewed during their visits to obtain information regarding their smoking history and HRQoL. They were divided into three groups according to smoking status (sustained quitters, quit ≥5 years; quitters, quit <5 years; and smokers, smoking at least one cigarette/day). The effects of the duration of cessation on HRQoL and hospital admission were analyzed using a multinomial logistic model.ResultsA total of 117 participants with moderate COPD met the inclusion criteria, who were comprised of 41 sustained quitters, 40 quitters, and 36 smokers. Several features were similar across the groups. Most of them were married elderly men (aged >64 years) with low-to-middle level of education, who smoked more than 33 cigarettes per day and had high levels of adherence to the medication regimen. The results showed that sustained quitters were less likely to have respiratory symptoms (cough, phlegm and dyspnea) than smokers (odds ratio 0.02, confidence interval 0–0.12; P<0.001). The hospital admission rate per year was increased in quitters compared to smokers (odds ratio 4.5, confidence interval 1.91–10.59; P<0.005).ConclusionA longer duration of quitting smoking will increase the benefits to COPD patients, even if they experience increased episodic respiratory symptoms in the early period of the cessation. Thus, the findings of this study show the benefits of early smoking cessation.

show abstract

“…A review by Niesink and colleagues (76) identified 10 education interventions, nine of which also included exercise training. Other elements of the programs included support, relaxation training, smoking cessation, breathing retraining, recreational activities and occupational therapy.…”

Section: Discussionmentioning

confidence: 99%

The Effects of a Telehealth Coping Skills Intervention on Outcomes in Chronic Obstructive Pulmonary Disease

Blumenthal

Emery

Smith

et al. 2014

Psychosomatic Medicine

View full text Add to dashboard Cite

Objective Chronic obstructive pulmonary disease (COPD) is associated with increased morbidity and mortality and reduced quality of life. Novel interventions are needed to improve outcomes in COPD patients. The present study assessed the effects of a telephone-based coping skills intervention on psychological and somatic quality of life and on the combined medical endpoint of COPD-related hospitalizations and all-cause mortality. Methods We conducted a dual-site, randomized clinical trial with assessments at baseline and after 16 weeks of treatment. The study population comprised 326 outpatients with COPD aged 38 to 81 years, randomized to Coping Skills training (CST) or to COPD Education (COPD-ED). Patients completed a battery of quality of life (QoL) instruments, pulmonary function tests, and functional measures and were followed for up to 4.4 years to assess medical outcomes. Results The CST group exhibited greater improvements in psychological QoL compared to controls (P = .001), including less depression (Cohen’s d=0.22 [95%CI 0.08, 0.36]) and anxiety (d=0.17 [95%CI 0.02, 0.33]), and better overall mental health (d=0.17 [95%CI 0.03, 0.32]), emotional role functioning (d= 0.29 [95%CI 0.10, 0.48]), vitality (d= 0.27 [95%CI 0.11, 0.42]), and social functioning (d= 0.21 [95%CI 0.03, 0.38]). A significant baseline psychological QoL by Treatment group interaction revealed that CST with lower QoL at baseline achieved even greater improvements in psychological QoL compared to COPE-ED. CST participants also exhibited greater improvements in Somatic QoL (P = .042), including greater improvements in pulmonary QoL (d= 0.13 [95%CI 0.01, 0.24]), less fatigue (d= 0.34 [95%CI 0.18, 0.50]), and less shortness of breath (d= 0.11 [95%CI −0.01, 0.23]) and greater improvement in distance walked on the 6 Minute Walk Test (d= 0.09 [95%CI 0.01, 0.16]). However, there was no significant difference in risk of time to COPD-related hospitalization or all-cause mortality between CST (34 events) and COPD-ED (32 events) (P= 0.430). Conclusions A telehealth coping skills training intervention produced clinically meaningful improvements in quality of life and functional capacity, but no overall improvement in risk of COPD-related hospitalization and all-cause mortality. Trial Registration clinicaltrials.gov Identifier NCT00736268

show abstract

Systematic review of the effects of chronic disease management on quality-of-life in people with chronic obstructive pulmonary disease

Cited by 51 publications

References 34 publications

Identifying potentially cost effective chronic care programs for people with COPD

Identifying potentially cost effective chronic care programs for people with COPD

Does the duration of smoking cessation have an impact on hospital admission and health-related quality of life amongst COPD patients?

The Effects of a Telehealth Coping Skills Intervention on Outcomes in Chronic Obstructive Pulmonary Disease

Contact Info

Product

Resources

About