Nguyen 2008.
| Methods | A randomised controlled trial. | |
| Participants | Patients: 50 patients with moderate to severe COPD who were current Internet users were assigned to one of two dyspnoea management intervention programs, in California or Seattle. Patients were recruited from web and non‐web sources, including distribution lists, chest clinic referrals, and support groups both real and digital. | |
| Interventions | Intervention: The Internet based dyspnoea management intervention program (eDSMP) focused on education, skills training and ongoing support for dyspnoea self management and was delivered via a personal digital assistant or Internet. Control: The face to face dyspnoea management intervention program (fDSMP) delivered the same content via education sessions, reinforcement contacts and peer interactions: all face to face. |
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| Outcomes | Evaluations were performed at 3 and 6 months. 1. Dyspnoea with activities of daily living,and quality of life as measured with the Chronic Respiratory Questionnaire. 2. Exercise behaviour exercise performance. 3. COPD exacerbations were also measured. 4. Self‐efficacy and social support were measured as mediators. 5. At the final visit a satisfaction survey and a semi‐structured interview were performed. |
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| Notes | ||
| Risk of bias | ||
| Bias | Authors' judgement | Support for judgement |
| Random sequence generation (selection bias) | Low risk | "an investigator who was not involved in the day‐to‐day study operations generated the randomisation sequence using the SPSS version 14.0 random sequence generator feature" |
| Allocation concealment (selection bias) | Low risk | "separate sealed opaque envelopes." |
| Blinding (performance bias and detection bias) All outcomes | High risk | Unable to blind study nurse to treatment assignment |
| Incomplete outcome data (attrition bias) All outcomes | High risk | Of 50 patients randomised, 39 remained after 6 months. Five control patients dropped out, 1 unable to schedule a visit and 4 discontinued due to schedule conflict, personal problems, losing interest or not eligible after baseline. Seven intervention patients discontinued. Four were unable or unwilling to access website, 1 schedule conflict, 1 patient had recurrent angina and one moved out of the area. |
| Selective reporting (reporting bias) | Low risk | All outcomes in methods are reported |
| Other bias | Low risk | No evidence of further bias |