Self-management interventions in patients with long-term. conditions: a structured review of approaches to reporting

Transcription

1 Journal of Comorbidity 2014;4:29 37 doi: /joc Supplementary material Self-management interventions in patients with long-term conditions: a structured review of approaches to reporting inclusion, assessment, and outcomes in multimorbidity Cassandra Kenning 1, Peter A. Coventry 2, Peter Bower 3 1 NIHR School for Primary Care Research, Centre for Primary Care, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; 2 NIHR Collaboration for Applied Health Research and Care Greater Manchester, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK; 3 NIHR Greater Manchester Primary Care Patient Safety Translational Research Centre, Centre for Primary Care, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK Correspondence: Cassandra Kenning, The University of Manchester, NIHR School for Primary Care Research, Centre for Primary Care, Institute of Population Health, 5th floor, Williamson Building, Oxford Road, Manchester M13 9PL, UK. Tel.: +44 (0) ; Cassandra.kenning@manchester.ac.uk 1

2 Supplementary Materials and Methods Cochrane reviews screened for each exemplar condition and reason for exclusion Type 2 diabetes mellitus The search strategy identified 16 potentially relevant reviews. Ten reviews were excluded based on their abstracts: protocol only (n=2), not self-management intervention (n=5), included patients with type 1 diabetes (n=2), and patients with diabetic kidney disease (n=1). Six reviews were included with a total of 73 unique trials (see Figure 1). None of the diabetes reviews reported using the presence of other conditions in their inclusion/exclusion criteria. Only one review (Hawthorne et al., 2008) reported the presence of specific comorbid conditions (for the total sample of included trials, 23.5% also had cardiovascular disease and 75.5% had hypertension). Half of the reviews (Deakin et al., 2009; Hawthorne et al., 2008; Malanda, 2012) reported if any of the trials included in the review had excluded patients based on multimorbidities. None of the reviews reflected on the impact of the inclusion/exclusion of participants with multimorbidities on the external validity of the trials or on their own conclusions about generalizability of the review results. Coronary heart disease (CHD) The search identified 15 potentially relevant reviews. Twelve reviews were excluded based on their abstracts: not self-management intervention (n=8), primary prevention of CHD (n=3), diagnosis of coronary heart failure and not CHD (n=1). Three reviews were included with a total of 55 unique trials (see Figure 2). None of the CHD reviews reported using the presence of other conditions in their inclusion/exclusion criteria. Only one review (Heran et al., 2011) commented on the fact that most of the included trials had excluded participants with multimorbidity and stated that this 2

3 may have accounted for the exclusion of up to 60% of the patients considered for the trials. The Heran review also discussed the implications of these exclusions in terms of external validity of the studies and that further randomised controlled trials are required in groups of CHD patients more representative of usual clinical practice. Chronic obstructive pulmonary disease (COPD) The search identified five potentially relevant reviews. Three reviews were excluded based on their abstracts: not self-management intervention (n=3). Two reviews were included with a total of 36 unique trials (see Figure 3). Neither COPD review reported using the presence of other conditions in their inclusion/exclusion criteria. Also, neither of the reviews discussed the impact of exclusion of patients with multimorbidities on the outcomes or external validity of the results. Only one of the reviews (Effing et al., 2009) commented on multimorbidity at all in reference to difficulties in obtaining detailed event data. 3

4 Supplementary Table 1 List of standardized a terms for self-management interventions searched in the Cochrane Database of Systemic Reviews. Intervention search terms used #1 (self next administer*) in Trials #2 MeSH descriptor: [Self Administration] this term only #3 MeSH descriptor: [Self Care] this term only #4 self care or (selfcare) or (self next manage*) or (selfmonitor*) or (self next monitor*) in Trials #5 (selfhelp) or self help or (self next diagnos*) or (selfdiagnos*) in Trials #6 (self next assess*) or (selfassess*) in Trials #7 MeSH descriptor: [Blood Glucose Self-Monitoring] this term only #8 self initiated intervention in Trials #9 (self next initiated next intervent*) in Trials #10 MeSH descriptor: [Self Efficacy] this term only #11 MeSH descriptor: [Self Medication] this term only #12 self efficacy or (pharmacist* or pharmacy or pharmacies) near/2 support* in Trials #13 (pharmacist* or pharmacy or pharmacies) near/2 assist* or (pharmacist* or pharmacy or pharmacies) near/2 (advice or advis* or inform*) or pharmaceutical care in trials #14 (self next medicat*) or (selfmedicat*) or (self next remed*) or (selfremed*) in Trial #15 (self next treat*) or (selftreat*) or self cure or (selfcure) in Trials #16 MeSH descriptor: [Self-Help Groups] this term only #17 MeSH descriptor: [Social Support] explode all trees #18 (social next support*) in Trials #19 (group near/1 [support* or advice or advis* or monitor* or intervention* or train* or instruction or consult* or assist* or education or information]) in Trials #20 (peer near/1 [support* or advice or advis* or monitor* or intervention* or train* or instruction or consult* or assist* or education or information]) in Trials #21 (expert next patient*) or psychosocial support or (befriend*) or (health next trainer*) in Trials #22 MeSH descriptor: [Telemedicine] this term only #23 (telemedicine) or (telecare) or (telenursing) or (telemonitor*) or (telehealth) in Trials #24 MeSH descriptor: [Remote Consultation] this term only #25 (telephon* or remote or phone) near/2 (follow* or support or consult* or advice or advis* or intervention or train* or instruction or assist* or educate or education or information or monitor*) in Trials #26 case management or (action next plan*) or (management next plan*) or (management next program*) or (care next plan*) in Trials #27 (nurse near/2 educator*) in Trials #28 patient education in Trials #29 MeSH descriptor: [Patient Education as Topic] this term only #30 MeSH descriptor: [Case Management] this term only #31 (patient near/2 [education or advice or advis* or instruct* or educate or train*]) in Trials #32 consumer health information or patient information in Trials 4

5 Condition-specific search terms added to intervention search terms #33 MeSH descriptor: [Diabetes Mellitus, Type 2] this term only and with qualifiers: [Diagnosis DI] #34 diabetes or (diabet*) in Trials #35 MeSH descriptor: [Coronary Disease] this term only and with qualifiers: [Diagnosis DI] #36 coronary heart disease or CHD in Trials #37 MeSH descriptor: [Pulmonary Disease, Chronic Obstructive] this term only and with qualifiers: [Diagnosis DI] #38 chronic obstructive pulmonary disease or COPD in Trials a Adapted from the RECURSIVE study: a quantitative systematic review to identify those models of selfmanagement support associated with significant reductions in health services utilization (M. Panagioti, personal communication). CHD, coronary heart disease; COPD, chronic obstructive pulmonary disease; DM, diabetes mellitus; MeSH, Medical Subject Headings. 5

6 Supplementary Table 2 Cochrane reviews of self-management interventions in three exemplar conditions: type 2 diabetes mellitus, coronary heart disease, and chronic obstructive pulmonary disease. Publication Review title Number of trials included Deakin et al. (2009) Group based training for self-management strategies in people with type 2 diabetes mellitus 11 Duke et al. (2009) Individual patient education for people with type 2 diabetes mellitus Hawthorne et al. (2008) Culturally appropriate health education for type 2 diabetes mellitus in ethnic minority groups 9 11 Malanda et al. (2012) Pal et al. (2013) Vermeire et al. (2009) Brown et al. (2011) Heran et al. (2011) Lau et al. (2012) Effing et al. (2009) Kruis et al. (2013) Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin Computer-based diabetes self-management interventions for adults with type 2 diabetes mellitus Interventions for improving adherence to treatment recommendations in people with type 2 diabetes mellitus Patient education in the management of coronary heart disease Exercise-based cardiac rehabilitation for coronary heart disease Yoga for secondary prevention of coronary heart disease Self-management education for patients with chronic obstructive pulmonary disease Integrated disease management interventions for patients with chronic obstructive pulmonary disease

7 References Brown JPR, Clark AM, Dalal H, Welch K, Taylor RS. Patient education in the management of coronary heart disease. Cochrane Database Syst Rev 2011;12:CD Deakin TA, McShane CE, Cade JE, Williams R. Group based training for self-management strategies in people with type 2 diabetes mellitus. Cochrane Database Syst Rev 2009;2:CD Duke SAS, Colagiuri S, Colagiuri R. Individual patient education for people with type 2 diabetes mellitus. Cochrane Database Syst Rev 2009;1:CD Effing T, Monninkhof EEM, van der Valk PP, Zielhuis GGA, Walters EH, van der Palen JJ, et al. Selfmanagement education for patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2007;4:CD Hawthorne K, Robles Y, Cannings-John R, Edwards AGK. Culturally appropriate health education for type 2 diabetes mellitus in ethnic minority groups. Cochrane Database Syst Rev 2008;3:CD Heran BS, Chen JMH, Ebrahim S, Moxham T, Oldridge N, Rees K, et al. Exercise-based cardiac rehabilitation for coronary heart disease. Cochrane Database Syst Rev 2011;7:CD Kruis AL, Smidt N, Assendelft WJJ, Gussekloo J, Boland MRS, Rutten-van Mölken M, et al. Integrated disease management interventions for patients with chronic obstructive pulmonary disease. Cochrane Database Syst Rev 2013;10:CD Lau HLC, Kwong JSW, Yeung F, Chau PH, Woo J. Yoga for secondary prevention of coronary heart disease. Cochrane Database Syst Rev 2012;12:CD Malanda UL, Welschen LMC, Riphagen II, Dekker JM, Nijpels G, Bot SDM. Self-monitoring of blood glucose in patients with type 2 diabetes mellitus who are not using insulin. Cochrane Database Syst Rev 2012;1:CD Pal K, Eastwood SV, Michie S, Farmer AJ, Barnard ML, Peacock R, et al. Computer-based diabetes selfmanagement interventions for adults with type 2 diabetes mellitus. Cochrane Database Syst Rev 2013;3:CD Vermeire EIJJ, Wens J, Van Royen P, Biot Y, Hearnshaw H, Lindenmeyer A. Interventions for improving adherence to treatment recommendations in people with type 2 diabetes mellitus. Cochrane Database Syst Rev 2009;2:CD