Table 3.
Quality appraisal of included studies.
| Study (Year) | Intervention | Systematic reviews | Primary studies | |||||
|---|---|---|---|---|---|---|---|---|
| R-AMSTAR score | Participants | Summarya | RCTs (n) | Low-risk of biasc | Meta-analysis quality | Summaryb | ||
| Education/action plans | ||||||||
| Effing et al. 12 e | Self-management education with or without action plans | 34 | 2239 | High/High | 13 | 3 | High | High/High |
| Tan et al. 13 | Self-management education | 33 | 2103 | High/High | 12 | 2 | High | High/High |
| Turnock et al.14 d | Action plans | 39 | 367 | High/Low | 3 | 0 | High | High/High |
| Walters et al.15 d | Action plans – COPD exacerbations | 34 | 574 | High/Low | 5 | 1 | High | High/High |
| Complex interventions with an SM focus | ||||||||
| Bentsen et al.16 | Range of SM interventions | 26 | 529 | Low/Low | 4 | NR | NA | NA |
| Dickens et al.17 | Range of complex interventions | 35 | 3941 | High/High | 32 | 8 | Medium | High/Med. |
| Harrison et al.18 | Range of SM – following COPD exacerbation | 30 | 1115 | Low/High | 7 | NR | NA | NA |
| Kruis et al.19 | Range of IDM interventions | 37 | 2997 | High/High | 26 | 5 | High | High/High |
| Zwerink et al.20e | Range of SM interventions | 39 | 3688 | High/High | 29 | 9 | High | High/High |
| Jordan et al.21 | Range of SM – following exacerbation | 40 | 1502 | High/High | 10 | 1 | High | High/High |
| Pulmonary rehabilitation | ||||||||
| McCarthy et al.22 | Pulmonary rehabilitation | 41 | 3822 | High/High | 65 | 17 | High | High/High |
| Telehealth | ||||||||
| Cruz et al.23 | Home telemonitoring | 33 | 587 | High/Low | 9 | 2 | High | High/High |
| Kamei et al.24 | Telehome monitoring-based telenursing | 30 | 550 | Low/Low | 9 | 6 | Medium | Low/Med. |
| Lundell et al.25 | Telehealth – making pulmonary rehabilitation accessible | 36 | 982 | High/Low | 9 | 2 | Low | High/Low |
| McLean et al.26 | Telehealth | 39 | 1004 | High/High | 10 | 0 | High | High/High |
| Outreach nursing programmes | ||||||||
| Wong et al.27 | Home care by outreach nursing | 37 | 1498 | High/High | 9 | 4 | High | High/High |
R-AMSTAR: Revised Assessment of Multiple Systematic Reviews; COPD: chronic obstructive pulmonary disease; IDM: integrated disease management; RCTs: randomized controlled trials; SM: self-management; NR: not reported; NA: not applicable.
aSummary includes R-AMSTAR score/number of participants. Papers judged to be of higher quality if scored ≥31 and lower quality if scored <31. Reviews judged to be of lower impact if total participant numbers are fewer than 1000.
bSummary includes risk of bias/meta-analysis quality score. If >50% of the included RCTs were at high risk of bias, review is rated as high risk of bias. The meta-analysis quality was evaluated using Higgins et al.’s quality assessment tool and results categorized into high-, medium- and low-quality meta-analysis.
cNumber of the total primary studies identified as being at low risk of bias.
dWalter’s Cochrane review (CR) is an update of Turnock’s CR.
eZwerink’s CR is an update of Effing’s CR. Note: In Zwerink’s update, they chose to exclude studies with education as the only active intervention.