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Introdução: Programas de self-management têm como objectivo habilitar os
pacientes com estratégias necessárias para levar a cabo procedimentos
específicos para a patologia. A última revisão sistemática sobre selfmanagament
em DPOC foi realizada em 2007, concluindo-se que ainda não
era possível fornecer dados claros e suficientes acerca de recomendações
sobre a estrutura e conteúdo de programas de self-managament na DPOC. A
presente revisão tem o intuito de complementar a análise da revisão anterior,
numa tentativa de inferir a influência do ensino do self-management na DPOC.
Objectivos: verificar a influência dos programas de self-management na
DPOC, em diversos indicadores relacionados com o estado de saúde do
paciente e na sua utilização dos serviços de saúde.
Estratégia de busca: pesquisa efectuada nas bases de dados PubMed e
Cochrane Collaboration (01/01/2007 – 31/08/2010). Palavras-chave: selfmanagement
education, self-management program, COPD e pulmonary
rehabilitation.
Critérios de Selecção: estudos randomizados sobre programas de selfmanagement
na DPOC.
Extracção e Análise dos Dados: 2 investigadores realizaram,
independentemente, a avaliação e extracção de dados de cada artigo.
Resultados: foram considerados 4 estudos randomizados em selfmanagement
na DPOC nos quais se verificaram benefícios destes programas
em diversas variáveis: qualidade de vida a curto e médio prazo, utilização dos
diferentes recursos de saúde, adesões a medicação de rotina, controle das
exacerbações e diminuição da sintomatologia. Parece não ocorrer alteração na
função pulmonar e no uso de medicação de emergência, sendo inconclusivo o
seu efeito na capacidade de realização de exercício.
Conclusões: programas de self-management aparentam ter impacto positivo
na qualidade de vida, recurso a serviços de saúde, adesão à medicação,
planos de acção e níveis de conhecimento da DPOC. Discrepâncias nos
critérios de selecção das amostras utilizadas, períodos de seguimento
desiguais, consistência das variáveis mensuradas, condicionam a informação
disponibilizada sobre este assunto.
Background: Self-management programs aim to enable patients with skills needed to carry out specific procedures to the disease. The last systematic review of self-managament in COPD was conducted in 2007, concluding that it was not possible to provide clear and sufficient information about recommendations on its structure and content. This review is intended to complement the previous review in an attempt to infer the influence of teaching self-management in COPD. Objectives: verify the influence of COPD self-management education programmes in several indicators of this disease, assigned to the patients health status and use of health care services. Search strategy: the search was conducted through PubMed and Cochrane Collaboration databases (01 January 2007 until 31 August 2010). Keywords: self-management education, self-management program, COPD and pulmonary rehabilitation. Selection criteria: randomized trials of self-management education programmes in patients with COPD. Data collection and analysis: two reviewers conducted independently the assessment and data extraction of each article. Results: four randomized studies were considered in self-management in COPD in which benefits on several outcomes have been reported: short to medium term quality of life, routine medication adherence, health resources utilization, control of exacerbations and reduction in symptoms. It seems not to have any influence in lung function and use of rescue medication, being inconclusive its effect on exercise capacity. Conclusions: self-management programs appear to have positive impact on quality of life, health services utilization, medication compliance, action plan and levels of awareness of COPD. Discrepancies in the criteria for selection of samples used, uneven follow-up periods, and consistency of the variables measured, restrict the information on this subject.
Background: Self-management programs aim to enable patients with skills needed to carry out specific procedures to the disease. The last systematic review of self-managament in COPD was conducted in 2007, concluding that it was not possible to provide clear and sufficient information about recommendations on its structure and content. This review is intended to complement the previous review in an attempt to infer the influence of teaching self-management in COPD. Objectives: verify the influence of COPD self-management education programmes in several indicators of this disease, assigned to the patients health status and use of health care services. Search strategy: the search was conducted through PubMed and Cochrane Collaboration databases (01 January 2007 until 31 August 2010). Keywords: self-management education, self-management program, COPD and pulmonary rehabilitation. Selection criteria: randomized trials of self-management education programmes in patients with COPD. Data collection and analysis: two reviewers conducted independently the assessment and data extraction of each article. Results: four randomized studies were considered in self-management in COPD in which benefits on several outcomes have been reported: short to medium term quality of life, routine medication adherence, health resources utilization, control of exacerbations and reduction in symptoms. It seems not to have any influence in lung function and use of rescue medication, being inconclusive its effect on exercise capacity. Conclusions: self-management programs appear to have positive impact on quality of life, health services utilization, medication compliance, action plan and levels of awareness of COPD. Discrepancies in the criteria for selection of samples used, uneven follow-up periods, and consistency of the variables measured, restrict the information on this subject.
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Instituto Politécnico do Porto. Escola Superior de Tecnologia da Saúde do Porto