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Qualitative systematic review of barriers and facilitators to self-management of chronic obstructive pulmonary disease: views of patients and healthcare professionals

Lookup NU author(s): Dr Siân Russell, Dr Dapo Ogunbayo, Professor Barbara Hanratty, Fiona Beyer, Professor Eileen KanerORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Background: Self-management interventions for chronic obstructive pulmonary disease (COPD) can improve quality of life, reduce hospital admissions, and improve symptoms. However, many factors impede engagement for patients and healthcare professionals. Qualitative research, with its focus on subjective experience, can provide invaluable insights into such factors.Design and Methods: A systematic review and synthesis of qualitative evidence on COPD self-management from the perspective of patients and healthcare practitioners. Articles were appraised and data extracted for analysis and synthesis following a systematic search and screening.Results: Twenty-two articles were reviewed. Patients adapt to COPD, learning from experience, suggesting that learning to self-manage is a protracted process. The emotional needs of COPD patients are considerable; frustration, depression, and anxiety are common. Patients experience an assortment of losses, facing limitations on their lifestyle and social interaction. Over time, COPD can consume their existence, reducing motivation. Healthcare practitioners may not have sufficient time, resources, or appropriate skills or confidence to effectively support patients’ self-management, particularly in regard to emotional and psychological needs. This can compound patients’ capability to engage in self-management. Conclusions: For COPD self-management to be effective, patients’ psychosocial needs must be prioritised alongside medication and exacerbation management. In addition, patients’ personal beliefs regarding COPD and its management should be reviewed periodically to avoid problematic behaviours and enhance positive adaptions to the disease. Patients with COPD are not a homogenous group and no one intervention will prove effective for all. Finally, healthcare practitioners require greater education, training, and support to successfully assist patients.

Publication metadata

Author(s): Russell S, Ogunbayo OJ, Newham JJ, Heslop-Marshall K, Netts P, Hanratty B, Beyer F, Kaner E

Publication type: Article

Publication status: Published

Journal: npj Primary Care Respiratory Medicine

Year: 2018

Volume: 28

Online publication date: 17/01/2018

Acceptance date: 30/11/2017

Date deposited: 17/01/2018

ISSN (electronic): 2055-1010

Publisher: Nature Publishing Group


DOI: 10.1038/s41533-017-0069-z


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