| 1.1 SGRQ: short‐term (≤ 6 months) |
16 |
|
Mean Difference (IV, Random, 95% CI) |
Subtotals only |
| 1.1.1 SGRQ: total |
16 |
1788 |
Mean Difference (IV, Random, 95% CI) |
‐3.78 [‐6.29, ‐1.28] |
| 1.1.2 SGRQ: symptoms |
13 |
1327 |
Mean Difference (IV, Random, 95% CI) |
‐1.56 [‐5.66, 2.53] |
| 1.1.3 SGRQ: activity |
13 |
1320 |
Mean Difference (IV, Random, 95% CI) |
‐3.04 [‐5.80, ‐0.28] |
| 1.1.4 SGRQ: impact |
13 |
1322 |
Mean Difference (IV, Random, 95% CI) |
‐3.76 [‐5.94, ‐1.57] |
| 1.2 SGRQ: medium‐term (> 6 to 15 months) |
18 |
|
Mean Difference (IV, Random, 95% CI) |
Subtotals only |
| 1.2.1 SGRQ: total |
18 |
4321 |
Mean Difference (IV, Random, 95% CI) |
‐3.89 [‐6.16, ‐1.63] |
| 1.2.2 SGRQ: symptoms |
12 |
2628 |
Mean Difference (IV, Random, 95% CI) |
‐3.88 [‐7.75, ‐0.02] |
| 1.2.3 SGRQ: activity |
12 |
2608 |
Mean Difference (IV, Random, 95% CI) |
‐2.57 [‐5.53, 0.38] |
| 1.2.4 SGRQ: impact |
12 |
2610 |
Mean Difference (IV, Random, 95% CI) |
‐3.34 [‐6.26, ‐0.41] |
| 1.3 SGRQ: long‐term (> 15 months) |
4 |
|
Mean Difference (IV, Random, 95% CI) |
Subtotals only |
| 1.3.1 SGRQ: total |
4 |
1090 |
Mean Difference (IV, Random, 95% CI) |
‐0.69 [‐3.31, 1.93] |
| 1.3.2 SGRQ: symptoms |
3 |
279 |
Mean Difference (IV, Random, 95% CI) |
2.35 [‐5.49, 10.19] |
| 1.3.3 SGRQ: activity |
3 |
278 |
Mean Difference (IV, Random, 95% CI) |
‐2.87 [‐6.17, 0.43] |
| 1.3.4 SGRQ: impact |
3 |
270 |
Mean Difference (IV, Random, 95% CI) |
‐2.21 [‐4.71, 0.29] |
| 1.4 Subgroup analysis SGRQ (total score, medium‐term) based on type of setting |
18 |
4321 |
Mean Difference (IV, Random, 95% CI) |
‐3.89 [‐6.16, ‐1.63] |
| 1.4.1 Primary care |
6 |
1545 |
Mean Difference (IV, Random, 95% CI) |
‐1.18 [‐3.55, 1.20] |
| 1.4.2 Secondary care |
9 |
2326 |
Mean Difference (IV, Random, 95% CI) |
‐1.38 [‐3.23, 0.47] |
| 1.4.3 Tertiary care |
3 |
450 |
Mean Difference (IV, Random, 95% CI) |
‐14.58 [‐21.56, ‐7.61] |
| 1.5 Subgroup analysis SGRQ (total score, medium‐term) based on study design |
18 |
4321 |
Mean Difference (IV, Random, 95% CI) |
‐3.89 [‐6.16, ‐1.63] |
| 1.5.1 RCT |
15 |
2901 |
Mean Difference (IV, Random, 95% CI) |
‐4.98 [‐7.93, ‐2.02] |
| 1.5.2 Cluster‐RCT |
3 |
1420 |
Mean Difference (IV, Random, 95% CI) |
‐0.38 [‐1.60, 0.83] |
| 1.6 Subgroup analysis SGRQ (total score, medium‐term) based on dominant component of intervention |
17 |
4099 |
Mean Difference (IV, Random, 95% CI) |
‐4.20 [‐6.66, ‐1.73] |
| 1.6.1 Education |
2 |
294 |
Mean Difference (IV, Random, 95% CI) |
0.15 [‐2.70, 3.00] |
| 1.6.2 Self‐management |
5 |
1825 |
Mean Difference (IV, Random, 95% CI) |
‐1.62 [‐4.01, 0.77] |
| 1.6.3 Telemonitoring |
2 |
195 |
Mean Difference (IV, Random, 95% CI) |
‐18.33 [‐26.72, ‐9.94] |
| 1.6.4 Exercise |
4 |
175 |
Mean Difference (IV, Random, 95% CI) |
‐3.92 [‐9.95, 2.11] |
| 1.6.5 Structural follow‐up |
5 |
1610 |
Mean Difference (IV, Random, 95% CI) |
‐4.19 [‐9.48, 1.09] |
| 1.7 Subgroup analysis SGRQ (total score, medium‐term) based on region |
18 |
4321 |
Mean Difference (IV, Random, 95% CI) |
‐3.89 [‐6.16, ‐1.63] |
| 1.7.1 North America |
4 |
1147 |
Mean Difference (IV, Random, 95% CI) |
‐2.50 [‐4.98, ‐0.02] |
| 1.7.2 Northwestern Europe |
4 |
1286 |
Mean Difference (IV, Random, 95% CI) |
‐0.12 [‐1.98, 1.74] |
| 1.7.3 Southern Europe |
3 |
227 |
Mean Difference (IV, Random, 95% CI) |
‐11.42 [‐17.38, ‐5.45] |
| 1.7.4 Oceania |
3 |
380 |
Mean Difference (IV, Random, 95% CI) |
‐0.23 [‐2.61, 2.16] |
| 1.7.5 East Asia |
3 |
385 |
Mean Difference (IV, Random, 95% CI) |
‐10.08 [‐21.59, 1.43] |
| 1.7.6 Western Asia |
1 |
896 |
Mean Difference (IV, Random, 95% CI) |
‐0.47 [‐2.95, 2.01] |
| 1.8 CRQ: short‐term (≤ 6 months) |
5 |
|
Mean Difference (IV, Random, 95% CI) |
Subtotals only |
| 1.8.1 CRQ: dyspnoea |
4 |
277 |
Mean Difference (IV, Random, 95% CI) |
0.80 [‐0.01, 1.62] |
| 1.8.2 CRQ: fatigue |
5 |
314 |
Mean Difference (IV, Random, 95% CI) |
0.71 [‐0.19, 1.62] |
| 1.8.3 CRQ: emotion |
5 |
314 |
Mean Difference (IV, Random, 95% CI) |
0.45 [‐0.26, 1.17] |
| 1.8.4 CRQ: mastery |
5 |
314 |
Mean Difference (IV, Random, 95% CI) |
0.72 [‐0.08, 1.52] |
| 1.9 CRQ: medium‐term (> 6 to 15 months) |
3 |
|
Mean Difference (IV, Random, 95% CI) |
Subtotals only |
| 1.9.1 CRQ: dyspnoea |
2 |
219 |
Mean Difference (IV, Random, 95% CI) |
0.29 [‐0.88, 1.46] |
| 1.9.2 CRQ: fatigue |
3 |
255 |
Mean Difference (IV, Random, 95% CI) |
0.37 [‐0.53, 1.26] |
| 1.9.3 CRQ: emotion |
3 |
255 |
Mean Difference (IV, Random, 95% CI) |
0.36 [‐0.84, 1.57] |
| 1.9.4 CRQ: mastery |
3 |
255 |
Mean Difference (IV, Random, 95% CI) |
0.76 [‐0.41, 1.94] |
| 1.10 CRQ: long‐term (> 15 months) |
3 |
|
Mean Difference (IV, Random, 95% CI) |
Subtotals only |
| 1.10.1 CRQ: dyspnoea |
2 |
151 |
Mean Difference (IV, Random, 95% CI) |
0.47 [‐0.31, 1.25] |
| 1.10.2 CRQ: fatigue |
3 |
184 |
Mean Difference (IV, Random, 95% CI) |
0.46 [0.06, 0.85] |
| 1.10.3 CRQ: emotion |
3 |
184 |
Mean Difference (IV, Random, 95% CI) |
0.52 [0.10, 0.95] |
| 1.10.4 CRQ: mastery |
3 |
184 |
Mean Difference (IV, Random, 95% CI) |
0.83 [0.41, 1.26] |
| 1.11 SF‐36 |
5 |
|
Mean Difference (IV, Random, 95% CI) |
Subtotals only |
| 1.11.1 SF‐36 MCS score |
5 |
3699 |
Mean Difference (IV, Random, 95% CI) |
0.36 [‐0.38, 1.11] |
| 1.11.2 SF‐36 PCS score |
5 |
3704 |
Mean Difference (IV, Random, 95% CI) |
1.06 [‐0.67, 2.79] |
| 1.12 General health QoL: SIP mean difference |
2 |
|
Mean Difference (IV, Random, 95% CI) |
Subtotals only |
| 1.12.1 SIP total |
2 |
183 |
Mean Difference (IV, Random, 95% CI) |
‐1.06 [‐3.00, 0.89] |
| 1.12.2 SIP: physical |
2 |
183 |
Mean Difference (IV, Random, 95% CI) |
‐2.63 [‐5.55, 0.30] |
| 1.12.3 SIP: psychosocial |
2 |
183 |
Mean Difference (IV, Random, 95% CI) |
‐0.86 [‐3.17, 1.44] |
| 1.13 Functional exercise capacity: 6MWD |
25 |
|
Mean Difference (IV, Random, 95% CI) |
Subtotals only |
| 1.13.1 6MWD: short‐term (≤ 6 months) |
17 |
1390 |
Mean Difference (IV, Random, 95% CI) |
52.56 [32.39, 72.74] |
| 1.13.2 6MWD: medium‐term (> 6 months to 15 months) |
13 |
2071 |
Mean Difference (IV, Random, 95% CI) |
44.69 [24.01, 65.37] |
| 1.13.3 6MWD: long‐term (> 15 months) |
6 |
7288 |
Mean Difference (IV, Random, 95% CI) |
48.43 [16.37, 80.49] |
| 1.14 Subgroup analysis 6MWD (medium‐term) based on type of setting |
13 |
2071 |
Mean Difference (IV, Random, 95% CI) |
43.21 [24.97, 61.44] |
| 1.14.1 Primary care |
2 |
79 |
Mean Difference (IV, Random, 95% CI) |
59.65 [21.96, 97.33] |
| 1.14.2 Secondary or tertiary care |
7 |
1368 |
Mean Difference (IV, Random, 95% CI) |
25.01 [‐0.20, 50.21] |
| 1.14.3 Tertiary care |
4 |
624 |
Mean Difference (IV, Random, 95% CI) |
60.41 [35.87, 84.96] |
| 1.15 Subgroup analysis 6MWD (medium‐term) based on dominant component of intervention |
13 |
2071 |
Mean Difference (IV, Random, 95% CI) |
43.21 [24.97, 61.44] |
| 1.15.1 Education |
1 |
85 |
Mean Difference (IV, Random, 95% CI) |
16.30 [‐20.63, 53.23] |
| 1.15.2 Self‐management |
1 |
36 |
Mean Difference (IV, Random, 95% CI) |
1.70 [‐52.65, 56.05] |
| 1.15.3 Telemonitoring |
2 |
195 |
Mean Difference (IV, Random, 95% CI) |
59.94 [42.59, 77.29] |
| 1.15.4 Exercise |
4 |
189 |
Mean Difference (IV, Random, 95% CI) |
68.21 [44.75, 91.68] |
| 1.15.5 Structural follow‐up |
6 |
1566 |
Mean Difference (IV, Random, 95% CI) |
35.14 [2.83, 67.45] |
| 1.16 Subgroup analysis 6MWD (medium‐term) based on region |
13 |
2071 |
Mean Difference (IV, Random, 95% CI) |
43.21 [24.97, 61.44] |
| 1.16.1 Northwestern Europe |
3 |
221 |
Mean Difference (IV, Random, 95% CI) |
18.18 [‐7.87, 44.24] |
| 1.16.2 Southern Europe |
5 |
552 |
Mean Difference (IV, Random, 95% CI) |
61.73 [36.74, 86.71] |
| 1.16.3 East Asia |
4 |
559 |
Mean Difference (IV, Random, 95% CI) |
42.67 [13.94, 71.41] |
| 1.16.4 Western Asia |
1 |
739 |
Mean Difference (IV, Random, 95% CI) |
‐4.50 [‐23.63, 14.63] |
| 1.17 Maximal exercise capacity: cycle test (W‐max) |
4 |
298 |
Mean Difference (IV, Random, 95% CI) |
6.99 [2.96, 11.02] |
| 1.18 Respiratory‐related hospital admissions |
14 |
4207 |
Odds Ratio (M‐H, Random, 95% CI) |
0.64 [0.50, 0.81] |
| 1.18.1 Respiratory‐related hospital admissions: short‐term (≤ 6 months) |
3 |
377 |
Odds Ratio (M‐H, Random, 95% CI) |
0.60 [0.30, 1.22] |
| 1.18.2 Respiratory‐related hospital admissions: medium‐term (> 6 to 15 months) |
9 |
2449 |
Odds Ratio (M‐H, Random, 95% CI) |
0.60 [0.44, 0.81] |
| 1.18.3 Respiratory‐related hospital admissions: long‐term (> 15 months) |
2 |
1381 |
Odds Ratio (M‐H, Random, 95% CI) |
0.85 [0.59, 1.23] |
| 1.19 Subgroup analysis respiratory‐related hospital admissions (medium‐term) based on type of setting |
9 |
2449 |
Odds Ratio (M‐H, Random, 95% CI) |
0.60 [0.44, 0.81] |
| 1.19.1 Primary care |
2 |
225 |
Odds Ratio (M‐H, Random, 95% CI) |
0.89 [0.21, 3.76] |
| 1.19.2 Secondary or tertiary care |
7 |
2224 |
Odds Ratio (M‐H, Random, 95% CI) |
0.56 [0.42, 0.76] |
| 1.20 Subgroup analysis respiratory‐related hospital admissions (medium‐term) based on dominant component of intervention |
9 |
2449 |
Odds Ratio (M‐H, Random, 95% CI) |
0.60 [0.44, 0.81] |
| 1.20.1 Education |
2 |
854 |
Odds Ratio (M‐H, Random, 95% CI) |
0.83 [0.47, 1.45] |
| 1.20.2 Self‐management |
5 |
1353 |
Odds Ratio (M‐H, Random, 95% CI) |
0.55 [0.43, 0.71] |
| 1.20.3 Telemonitoring |
1 |
75 |
Odds Ratio (M‐H, Random, 95% CI) |
0.27 [0.09, 0.79] |
| 1.20.4 Structural follow‐up |
2 |
167 |
Odds Ratio (M‐H, Random, 95% CI) |
0.65 [0.08, 5.55] |
| 1.21 Subgroup analysis respiratory‐related hospital admissions (medium‐term) based on region |
8 |
2316 |
Odds Ratio (M‐H, Random, 95% CI) |
0.61 [0.44, 0.86] |
| 1.21.1 North America |
4 |
1788 |
Odds Ratio (M‐H, Random, 95% CI) |
0.69 [0.50, 0.94] |
| 1.21.2 Northwestern Europe |
1 |
201 |
Odds Ratio (M‐H, Random, 95% CI) |
0.43 [0.23, 0.82] |
| 1.21.3 Southern Europe |
2 |
235 |
Odds Ratio (M‐H, Random, 95% CI) |
0.35 [0.18, 0.68] |
| 1.21.4 Oceania |
1 |
92 |
Odds Ratio (M‐H, Random, 95% CI) |
1.89 [0.80, 4.45] |
| 1.22 All hospital admissions |
10 |
3244 |
Odds Ratio (M‐H, Random, 95% CI) |
0.75 [0.57, 0.98] |
| 1.22.1 All hospital admissions: short‐term (≤ 6 months) |
1 |
112 |
Odds Ratio (M‐H, Random, 95% CI) |
0.31 [0.14, 0.67] |
| 1.22.2 All hospital admissions: medium‐term (> 6 months to 15 months) |
5 |
1212 |
Odds Ratio (M‐H, Random, 95% CI) |
0.93 [0.71, 1.21] |
| 1.22.3 All hospital admissions: long‐term (> 15 months) |
4 |
1920 |
Odds Ratio (M‐H, Random, 95% CI) |
0.72 [0.45, 1.16] |
| 1.23 Hospital days per patient (all causes) |
14 |
3563 |
Mean Difference (IV, Random, 95% CI) |
‐2.27 [‐3.98, ‐0.56] |
| 1.23.1 Hospital days per patient (all causes): short‐term (≤ 6 months) |
2 |
273 |
Mean Difference (IV, Random, 95% CI) |
‐4.36 [‐6.41, ‐2.31] |
| 1.23.2 Hospital days per patient (all causes): medium‐term (> 6 to 15 months) |
10 |
2944 |
Mean Difference (IV, Random, 95% CI) |
‐1.73 [‐3.71, 0.25] |
| 1.23.3 Hospital days per patient (all causes): long‐term (> 15 months) |
2 |
346 |
Mean Difference (IV, Random, 95% CI) |
‐1.60 [‐6.12, 2.92] |
| 1.24 ED visits |
9 |
3005 |
Odds Ratio (M‐H, Random, 95% CI) |
0.69 [0.50, 0.93] |
| 1.25 Number of patients experiencing ≥ 1 exacerbation |
7 |
1378 |
Odds Ratio (M‐H, Random, 95% CI) |
0.96 [0.65, 1.42] |
| 1.25.1 Number of patients experiencing ≥ 1 exacerbation: short‐term (≤ 6 months) |
1 |
216 |
Odds Ratio (M‐H, Random, 95% CI) |
1.17 [0.68, 1.99] |
| 1.25.2 Number of patients experiencing ≥ 1 exacerbation: medium‐term (> 6 months to 15 months) |
4 |
861 |
Odds Ratio (M‐H, Random, 95% CI) |
0.72 [0.40, 1.27] |
| 1.25.3 Number of patients experiencing ≥ 1 exacerbation: long‐term (> 15 months) |
2 |
301 |
Odds Ratio (M‐H, Random, 95% CI) |
1.53 [0.90, 2.61] |
| 1.26 Number of patients using ≥ 1 course of oral steroids |
4 |
433 |
Odds Ratio (M‐H, Random, 95% CI) |
1.05 [0.66, 1.64] |
| 1.27 Number of patients using ≥ 1 course of antibiotics |
3 |
321 |
Odds Ratio (M‐H, Random, 95% CI) |
1.46 [0.51, 4.18] |
| 1.28 MRC dyspnoea score |
13 |
|
Mean Difference (IV, Random, 95% CI) |
Subtotals only |
| 1.28.1 MRC dyspnoea score: short‐term (≤ 6 months) |
8 |
1132 |
Mean Difference (IV, Random, 95% CI) |
‐0.33 [‐0.52, ‐0.15] |
| 1.28.2 MRC dyspnoea score: medium‐term (> 6 months to 15 months) |
7 |
2753 |
Mean Difference (IV, Random, 95% CI) |
‐0.61 [‐0.98, ‐0.23] |
| 1.28.3 MRC dyspnoea score: long‐term (> 15 months) |
3 |
7252 |
Mean Difference (IV, Random, 95% CI) |
‐0.37 [‐0.88, 0.14] |
| 1.29 Borg score |
3 |
145 |
Mean Difference (IV, Random, 95% CI) |
0.14 [‐0.70, 0.98] |
| 1.30 Mortality |
15 |
4745 |
Odds Ratio (M‐H, Random, 95% CI) |
0.86 [0.59, 1.25] |
| 1.30.1 Mortality: short‐term (≤ 6 months) |
2 |
320 |
Odds Ratio (M‐H, Random, 95% CI) |
1.10 [0.41, 2.93] |
| 1.30.2 Mortality: medium‐term (> 6 months to 15 months) |
9 |
2603 |
Odds Ratio (M‐H, Random, 95% CI) |
0.80 [0.45, 1.43] |
| 1.30.3 Mortality: long‐term (> 15 months) |
4 |
1822 |
Odds Ratio (M‐H, Random, 95% CI) |
0.87 [0.48, 1.57] |
| 1.31 FEV₁ (litre) |
6 |
|
Mean Difference (IV, Random, 95% CI) |
Subtotals only |
| 1.31.1 FEV₁ (litre): short‐term (< 6 months) |
2 |
184 |
Mean Difference (IV, Random, 95% CI) |
0.19 [‐0.17, 0.55] |
| 1.31.2 FEV₁ (litre): medium‐term (> 6 months to 15 months) |
4 |
1344 |
Mean Difference (IV, Random, 95% CI) |
0.04 [‐0.05, 0.12] |
| 1.31.3 FEV₁ (litre): long‐term (> 15 months) |
3 |
1047 |
Mean Difference (IV, Random, 95% CI) |
0.05 [‐0.08, 0.18] |
| 1.32 FEV₁ (% predicted) |
15 |
|
Mean Difference (IV, Random, 95% CI) |
Subtotals only |
| 1.32.1 FEV₁ (% predicted): short‐term (≤ 6 months) |
7 |
954 |
Mean Difference (IV, Random, 95% CI) |
2.88 [1.35, 4.40] |
| 1.32.2 FEV₁ (% predicted) medium‐term (> 6 to 15 months) |
10 |
1902 |
Mean Difference (IV, Random, 95% CI) |
0.95 [‐0.20, 2.11] |
| 1.32.3 FEV₁ (% predicted): long‐term (> 15 months) |
5 |
7328 |
Mean Difference (IV, Random, 95% CI) |
1.18 [‐0.82, 3.18] |
| 1.33 Anxiety and depression (HADS) |
8 |
|
Mean Difference (IV, Random, 95% CI) |
Subtotals only |
| 1.33.1 HADS: anxiety |
8 |
1580 |
Mean Difference (IV, Random, 95% CI) |
0.09 [‐0.30, 0.47] |
| 1.33.2 HADS: depression |
8 |
1584 |
Mean Difference (IV, Random, 95% CI) |
‐0.20 [‐0.45, 0.05] |
| 1.34 SGRQ total score |
25 |
|
Mean Difference (IV, Random, 95% CI) |
Subtotals only |
| 1.34.1 Short‐term |
16 |
1788 |
Mean Difference (IV, Random, 95% CI) |
‐3.78 [‐6.29, ‐1.28] |
| 1.34.2 Medium‐term |
18 |
4321 |
Mean Difference (IV, Random, 95% CI) |
‐3.89 [‐6.16, ‐1.63] |
| 1.34.3 Long‐term |
4 |
1090 |
Mean Difference (IV, Random, 95% CI) |
‐0.69 [‐3.31, 1.93] |
