Effectiveness of Holistic Interventions for People with Severe Chronic Obstructive Pulmonary Disease Systematic Review of Controlled Clinical Trials 英文参考文献.docVIP

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Effectiveness of Holistic Interventions for People with Severe Chronic Obstructive Pulmonary Disease Systematic Review of Controlled Clinical Trials 英文参考文献.doc

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Effectiveness of Holistic Interventions for People with Severe Chronic Obstructive Pulmonary Disease Systematic Review of Controlled Clinical Trials 英文参考文献

EffectivenessofHolisticInterventionsforPeoplewith SevereChronicObstructivePulmonaryDisease: SystematicReviewofControlledClinicalTrials UlugbekNurmatov1,SusanBuckingham1,MarilynKendall2,ScottA.Murray2,PatrickWhite3, AzizSheikh1,HilaryPinnock1* 1AllergyandRespiratoryResearchGroup,CentreforPopulationHealthSciences,TheUniversityofEdinburgh,Edinburgh,Scotland,UnitedKingdom,2PrimaryPalliative CareResearchGroup,CentreforPopulationHealthSciences,TheUniversityofEdinburgh,Edinburgh,Scotland,UnitedKingdom,3DepartmentofPrimaryCareandPublic HealthSciences,King’sCollegeLondon,London,England,UnitedKingdom Abstract Background: Despite a well-recognised burden of disabling physical symptoms compounded by co-morbidities, psychologicaldistressandsocialisolation,theneedsofpeoplewithseverechronicobstructivepulmonarydisease(COPD) aretypicallypoorlyaddressed. Aim:ToassesstheeffectivenessofinterventionsdesignedtodeliverholisticcareforpeoplewithsevereCOPD. Methods: We searched 11 biomedical databases, three trial repositories (January 1990-March 2012; no language restrictions)andcontactedinternationalexpertstolocatepublished,unpublishedandin-progressrandomisedcontrolled trials(RCTs),quasi-RCTsandcontrolledclinicaltrials(CCTs)thatinvestigatedholisticinterventionstosupportpatientswith severeCOPDinanyhealthcarecontext.Theprimaryoutcomewashealth-relatedqualityoflife(HRQoL).Qualityassessment anddataextractionfollowedCochraneCollaborationmethodology.Weusedapiloteddataextractionsheetandundertook narrativesynthesis. Results:From2,866potentiallyrelevantpapers,weidentifiedthreetrials:twoRCTs(fromUnitedStatesandAustralia),and oneCCT(fromThailand):total216patients.Riskofbiaswasassessedasmoderateintwostudiesandhighinthethird.All the interventions were led by nurses acting in a co-ordinating role (e.g. facilitating community support in Thailand, providingcase-managementintheUSA,orco-ordinatinginpatientcareinAustralia).HRQoLimprovedsignificantlyinthe ThaiCCTcomparedtothe(verylimited)usualcare(p,0.001),