Table 3.
Reported intermediate and end outcomes: measures used and summary of findings
| Outcome (n, number of studies reporting the outcome) | Measures§ | Summary of findings [study references] |
|---|---|---|
| Process measures | ||
| Scheduled outpatient visits (n = 7) | Physician (GP) office visits[32,21,27,37,36]; Specialist/ outpatient hospital visits[32,38,37,22,36]; Nurse home visits[38,27,37] | +[27(nurse home visits), 36]
=[32,38,21,27(GP visits), 37,22(12 month follow-up)] −[22(24 month follow-up)] |
| Medication prescriptions (n = 5) | Total prescribed COPD-related medication[37,36]; new medications prescribed[23]; antibiotics[28,31]; oral steroids[28,31]; domiciliary oxygen[28]; inhaled bronchodilators[28] | +[37(oxygen and nebulizer), 36]
=[37,28,31,23] |
| Amount of patient education provided (n = 5) | Self-management education[20,36]; COPD education [20,21,27,24] | +[20,21,27,24,36] |
| Coordination of care (n = 2) | Number of GP-arranged follow-ups[27]; Patient assessed change in coordination of care[36] | +[36]
=[27] |
| Accessibility of care (n = 1) | Patient assessed change in accessibility of care[36] | +[36] |
| Intermediate outcomes | ||
| Disease specific knowledge (n = 5) | Deenen's respiratory knowledge questionnaire[M1,36]; Self-designed questionnaire (not validated)[20,27,37,24] | +[20,27,37,36]
=[24] |
| Self-management behaviour (n = 4) | Self-designed questionnaire (not validated)[27,35,31,36]; Patient-reported smoking cessation[35,31,36]; physical activity[36]; influenza vaccination[27]; pneumococcal vaccination[27] | +[36]
=[27,35,31] |
| Medication compliance (n = 4) | Self-designed questionnaire (not validated)[37,35,36,25]; Single-item[M2,25] and 4-point Likert scale questionnaire[M3,25] | +[36]
=[37,35,25] |
| Technical skills/self-efficacy (n = 4) | COPD Self-Efficacy Scale[M4,21,35]; Coping style questionnaire[M5, 35]; Inhalation checklist[M6, 35]; Walking self-efficacy[M7, 22]; Self-designed questionnaire (not validated)[37] | +[37,35(inhalation)]
=[21,35(self-efficacy and coping), 22] |
| Social support (n =2) | MOS social support survey[M8, 21,26] | =[21,26(tangible and emotional support, positive social interaction)]
−[26(affectionate support)] |
| End outcomes | ||
| Lung function (n = 7) | Post bronchodilators FEV1(litres)[32,31,22,29]; FEV1 (% predicted)[39,31,22,29,36]; FVC (litres); FEV1/FVC (%) [32] [32,36]; PEF rate (% predicted)[25] | +[31,25]
=[32,39,36] −[22,29] =[35,30,31,29,23,25] −[22] |
| Dyspnoea (n = 7) | MRC dyspnoea questionnaire[M9, 35]; CRQ-dyspnoea dimension[M10, 30,31,25]; UCSD Shortness of Breath Questionnaire[M11, 22]; Baseline and Transition Dyspnoea Indices (interview administered)[M12, 22]; BORG scale[M13, 23]; Self-developed questionnaire (not validated)[29] | |
| Symptoms (n = 9) | SGRQ-symptoms[M25, 32,21,26,27,37]; Memorial Symptom Assessment Scale[M26, 20]; General Health Questionnaire [M23, 39]; Symptoms checklist[M27, 35]; Self-developed questionnaire (not validated)[23] | =[20,32,21,26,27,37,35,39,23] |
| Physical functioning (n = 10) => Questionnaire based (n = 8) => Performance based (n = 2) | SF-36 physical functioning[M14, 20,21,31]; SF-12 physical functioning[M15, 37]; Barthel Index[M16, 39]; RAND-36 physical component[M17, 22]; COOP (adapted physical functioning item)[M18, 29]; Health Status Questionnaire[M19, 24] 6-minute walk test[M20, 32,22]; Shuttle Walk Test[M21, 31]; Treadmill Test[22] | + [20,29]
=[21,37,39,31,22,24] +[22(12 month follow-up)] =[32,31,22(24 month follow-up)] |
| Mental functioning (n = 11) | SF-36 mental health[M14, 20,21,31]; HAD[M22, 26,30]; Health Status Questionnaire [M19, 23]; SF-12 mental health [M15, 37]; General Health Questionnaire [M23, 39]; CRQ-emotion dimension [M10, 30,31,25]; CED-Depression Scale [M24, 22]; RAND-36 mental component [M17, 22]; COOP emotion components [M18, 29] | +[39,22(12 month follow-up), 29]
=[20,21,26,37,30,31,22(24 month follow-up), 29,23,25] |
| Health-related Quality of Life | SF-36[M14, 20,21,31]; SGRQ-total[M25, 32,21,26,27,37,36]; CRQ-total[M10, 30,31,22,25]; Subjective Well Being Scale[M28, 26]; Health Status Questionnaire[M19, 23]; SF-12[M15, 37]; QOL-RIO[M29,35]; General Health Questionnaire-total[M23, 39]; Quality of Well Being Scale[M30, 22]; COOP-total[M18, 21]; EQ–5D[M31, 36] | +[20,32(4 month follow-up), 37(SGRQ), 30,31(CRQ-fatigue and mastery), 22(12 month follow-up), 29,36(EQ-5D)] =[32(12 month follow-up), 21,26,27,37(SF-12), 35,39,31(SF-36), 22(24 month follow-up), 36(SGRQ), 25] |
| Health care utilization and costs (n = 19) | Hospital (re)admission[32,33,38,21,26,27,37,28,39,30,31,29,23,36,25]; Hospital LOS[37,28,39,30,31,22]; ED-visits[20,32,33,21,27,37,28,39,31,22,29,23,25]; Unscheduled outpatient visits[32,38,21,37,22,29,23,36]; Prescriptions[37,28,31,23,36]; Home visits[38]; Phone calls[22]; Sick leave[36]; Total costs[34,37,36] | +[37(prescriptions), 28(hospital LOS), 36(prescriptions)]
=[20,34,38,21,26,27,35(outpatient visits), 28,39,30,31, 22(ED-visits), 29,23,36(total costs), 25] −[32,33,38(readmissions), 35,30(hospital LOS), 22,23(outpatient visits), 36] |
| Mortality (n = 14) | All causes death[20,32,34,33,38,21,27,37,35,30,31,22,29,25] | =[20,32,34,33,38,21,27,37,35,30,31,22,29,25] |
Notes: References to included studies that applied this measure are indicated numerically; References to papers describing the validity/reliability of the measure or questionnaire are indicated with Mx.
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