Using a Taxonomy to Systematically Identify and Describe Self-Management Interventions Components in Randomized Trials for COPD

Monique Heijmans (), Rune Poortvliet, Marieke Van der Gaag, Ana I. González-González, Jessica Beltran Puerta, Carlos Canelo-Aybar, Claudia Valli, Marta Ballester, Claudio Rocha, Montserrat León Garcia, Karla Salas-Gama, Chrysoula Kaloteraki, Marilina Santero, Ena Niño de Guzmán, Cristina Spoiala, Pema Gurung, Saida Moaddine, Fabienne Willemen, Iza Cools, Julia Bleeker, Angelina Kancheva, Julia Ertl, Tajda Laure, Ivana Kancheva, Kevin Pacheco-Barrios, Jessica Zafra-Tanaka, Dimitris Mavridis, Areti Angeliki Veroniki, Stella Zevgiti, Georgios Seitidis, Pablo Alonso-Coello, Oliver Groene, Rosa Sunol and Carola Orrego
Additional contact information
Monique Heijmans: Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands
Rune Poortvliet: Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands
Marieke Van der Gaag: Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands
Ana I. González-González: Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
Jessica Beltran Puerta: Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain
Carlos Canelo-Aybar: Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain
Claudia Valli: Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain
Marta Ballester: Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
Claudio Rocha: Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain
Montserrat León Garcia: Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain
Karla Salas-Gama: Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain
Chrysoula Kaloteraki: Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain
Marilina Santero: Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain
Ena Niño de Guzmán: Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain
Cristina Spoiala: Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands
Pema Gurung: Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands
Saida Moaddine: Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands
Fabienne Willemen: Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands
Iza Cools: Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands
Julia Bleeker: Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands
Angelina Kancheva: Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands
Julia Ertl: Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands
Tajda Laure: Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands
Ivana Kancheva: Netherlands Institute for Health Services Research (NIVEL), 3513 Utrecht, The Netherlands
Kevin Pacheco-Barrios: Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
Jessica Zafra-Tanaka: Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
Dimitris Mavridis: Department of Primary Education, School of Education, University of Ioannina, 45110 Ioannina, Greece
Areti Angeliki Veroniki: Knowledge Translation Program, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON M5B 1W8, Canada
Stella Zevgiti: Department of Primary Education, School of Education, University of Ioannina, 45110 Ioannina, Greece
Georgios Seitidis: Department of Primary Education, School of Education, University of Ioannina, 45110 Ioannina, Greece
Pablo Alonso-Coello: Iberoamerican Cochrane Centre, Biomedical Research Institute Sant Pau (IIB Sant Pau), 08025 Barcelona, Spain
Oliver Groene: OptiMedis, 20095 Hamburg, Germany
Rosa Sunol: Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain
Carola Orrego: Avedis Donabedian Research Institute (FAD), 08037 Barcelona, Spain

IJERPH, 2022, vol. 19, issue 19, 1-24

Abstract: Self-management interventions (SMIs) may improve outcomes in Chronic Obstructive Pulmonary Disease (COPD). However, accurate comparisons of their relative effectiveness are challenging, partly due to a lack of clarity and detail regarding the intervention content being evaluated. This study systematically describes intervention components and characteristics in randomized controlled trials (RCTs) related to COPD self-management using the COMPAR-EU taxonomy as a framework, identifying components that are insufficiently incorporated into the design of the intervention or insufficiently reported. Overall, 235 RCTs published between 2010 and 2018, from a systematic review were coded using the taxonomy, which includes 132 components across four domains: intervention characteristics, expected patient (or caregiver) self-management behaviours, patient relevant outcomes, and target population characteristics. Risk of bias was also assessed. Interventions mainly focused on physical activity (67.4%), and condition-specific behaviours like breathing exercise (63.5%), self-monitoring (50.8%), and medication use (33.9%). Support techniques like education and skills-training, self-monitoring, and goal setting (over 35% of the RCTs) were mostly used for this. Emotional-based techniques, problem-solving, and shared decision-making were less frequently reported (less than 15% of the studies). Numerous SMIs components were insufficiently incorporated into the design of COPD SMIs or insufficiently reported. Characteristics like mode of delivery, intensity, location, and providers involved were often not described. Only 8% of the interventions were tailored to the target population’s characteristics. Outcomes that are considered important by patients were hardly taken into account. There is still a lot to improve in both the design and description of SMIs for COPD. Using a framework such as the COMPAR-EU SMI taxonomy may contribute to better reporting and to better informing of replication efforts. In addition, prospective use of the taxonomy for developing and reporting intervention content would further aid in building a cumulative science of effective SMIs in COPD.

Keywords: COPD; self-management; complex interventions; taxonomy; quality improvement; intervention content (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
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Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:19:y:2022:i:19:p:12685-:d:933084

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