Review articleThe effects of chronic obstructive pulmonary disease self-management interventions on improvement of quality of life in COPD patients: A meta-analysis

- Self-management programs improve patients' quality of life on all domains of the SGRQ: activity, impact, symptoms, and total.
- Self-management programs significantly improved exercise level.
- Self-management programs significantly improved chronic obstructive pulmonary disease self-efficacy level.

This article aimed to analyse the outcome of self-management randomised control trials and their impact upon chronic obstructive pulmonary disease patients' health outcomes using meta-analysis approach. PubMed, Scopus, CINAHL, Web of Science databases and Cochrane Library, were searched for articles between 1990 and December 2015 by two researchers. Self-management programs significantly improved patients' quality of life across all domains of the St George Respiratory Questionnaire (SGRQ) (activity −2.21 (95% CI: −3.61 to −0.80), p = 0.002; impact −3.30 (95% CI: −5.28 to −1.32), p = 0.001; symptoms −3.12 (95% CI: −4.94 to −1.03), p = 0.001; total −3.32 (95% CI: −4.60 to −2.04), p < 0.001), the six-minute walk test (−30.50 (95% CI: 3.32 to 57.68), p = 0.028), and across three domains of the chronic obstructive pulmonary disease self-efficacy scale (negative effect −1.22 (95% CI: −2.31 to −0.14), p = 0.027; physical exertion −1.27 (95% CI: −2.52 to −0.02), p = 0.047; behavioural risk factors −0.58 (95% CI: −0.99 to −0.16), p = 0.007). Subgroup analyses revealed that chronic obstructive pulmonary disease education (p < 0.01) was the strongest component with improvements on all aspects of the SGRQ and the six-minute walk test. Providing an exacerbation action plan significantly improved SGRQ activity and impact scores whilst exercise information had a positive effect on activity and symptom scores (p < 0.05). Interventions with a duration of less than five weeks (p < 0.05) significantly improved symptom and activity scores, in addition to the number of patient hospital admissions. Thus, self-management interventions are effective at improving the health outcomes of chronic obstructive pulmonary disease patients, especially when disease education is provided.