Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 4

Focusing on outcomes: Making the most of COPD interventions

Authors Noreen M Clark, Julia A Dodge, Martyn R Partridge, Fernando J Martinez

Published 7 October 2008 Volume 2009:4 Pages 61—77

DOI https://doi.org/10.2147/COPD.S4093

Review by Single-blind

Peer reviewer comments 3

Noreen M Clark1, Julia A Dodge1, Martyn R Partridge2, Fernando J Martinez3

1Center for Managing Chronic Disease, University of Michigan, Ann Arbor, MI, USA; 2Imperial College of Science, Technology and Medicine, London, England, UK; 3Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan, USA

Abstract: A number of excellent intervention studies related to clinical and psychosocial aspects of chronic obstructive pulmonary disease (COPD) have been undertaken in the recent past. A range of outcomes have been examined including pulmonary function, health care use, quality of life, anxiety and depression, ambulation, exercise capacity, and self-efficacy. The purpose of this narrative review was to a) consider clinical, psychosocial, and educational interventions for people living with COPD in light of the health related outcomes that they have produced, b) identify the type of interventions most associated with outcomes, c) examine work related to COPD interventions as it has evolved regarding theory and models compared to work in asthma, and d) explore implications for future COPD research. Studies reviewed comprised large scale comprehensive reviews including randomized clinical trials and meta-analysis as these forms of investigation engender the greatest confidence in clinicians and health care researchers. Extant research suggests that the most significant improvements in COPD health care utilization have been realized from interventions specifically designed to enhance disease management by patients. A range of interventions have produced modest changes in quality of life. Evidence of impact for other outcomes and for a particular type of intervention is not strong. Research in other chronic diseases, particularly asthma, suggests that interventions grounded in learning theory and models of behavior change can consistently produce desired results for patients and clinicians. Use of a model of self-regulation may enhance COPD interventions. Although the extent to which COPD efforts can benefit from the experience in other conditions is a question, more outcome focused intervention studies using more robust theoretical approaches may enhance COPD results, especially regarding health care use and quality of life.

Keywords: COPD, disease management, self-regulation

Creative Commons License This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License. By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.

Download Article [PDF] 

 

Other article by this author:

Educational and behavioral interventions for asthma: who achieves which outcomes? A systematic review

Noreen M Clark, Christopher Griffiths, Stephanie R Keteyian, et al

Journal of Asthma and Allergy 2010, 3:187-197

Published Date: 10 December 2010

Readers of this article also read:

Synthesis and characterization of a novel chemically designed (Globo)3–DTPA–KLH antigen

Hajmohammadi M, Siadat SD, Ghorbani M, Shafiee Ardestani M, Teimourian S, Asgari V, Ahangari Cohan R, Hajmohammadi M, Hajmohammadi A, Behzadi R, Rajabnezhad S, Namvar Asl N

Drug Design, Development and Therapy 2015, 9:217-239

Published Date: 22 December 2014

Findings of secondary corneal amyloidosis with ultrahigh-resolution optical coherence tomography

Araki-Sasaki K, Osakabe Y, Fukuoka H, Ideta R, Hirano K

Clinical Ophthalmology 2014, 8:2115-2119

Published Date: 14 October 2014

Tapentadol in the management of chronic low back pain: a novel approach to a complex condition?

Pergolizzi J, Alon E, Baron R, Bonezzi C, Dobrogowski J, Gálvez R, Jensen T, Kress H-G, Marcus MA, Morlion B, Perrot S, Treede R-D

Journal of Pain Research 2011, 4:203-210

Published Date: 21 July 2011

Potential role of stem cells in management of COPD

Tillie L Hackett, Darryl A Knight, Don D Sin

International Journal of Chronic Obstructive Pulmonary Disease 2010, 5:81-88

Published Date: 26 March 2010

Effects of pulmonary rehabilitation on exercise capacity in patients with COPD: A number needed to treat study

Gian Galeazzo Riario-Sforza, Cristoforo Incorvaia, Fulvia Paterniti, et al

International Journal of Chronic Obstructive Pulmonary Disease 2009, 4:315-319

Published Date: 21 August 2009

Pilot study of a cell phone-based exercise persistence intervention post-rehabilitation for COPD

Huong Q Nguyen, Dawn P Gill, Seth Wolpin, et al

International Journal of Chronic Obstructive Pulmonary Disease 2009, 4:301-313

Published Date: 5 August 2009

A systematic review of the cardiovascular risk of inhaled anticholinergics in patients with COPD

Daniel E Hilleman, Mark A Malesker, Lee E Morrow, Dan Schuller

International Journal of Chronic Obstructive Pulmonary Disease 2009, 4:253-263

Published Date: 30 June 2009