School of Health & Society, Faculty of Social Sciences, University of Wollongong, Wollongong, NSW, Australia.
Discipline of Medical and Exercise Science, School of Medicine, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, Australia.
COPD. 2021 Jun;18(3):367-373. doi: 10.1080/15412555.2021.1872061. Epub 2021 Apr 26.
Chronic obstructive pulmonary disease (COPD) is a chronic progressive lung disease which imposes significant health and economic burdens on societies. Self-management is beneficial in controlling and managing COPD and health literacy (HL) is a major driver of COPD self-management. This review aims to summarize the most recent evidence on the effectiveness of HL driven COPD self-management interventions using randomized controlled trials (RCTs). Eight data bases including Science Citation Index, Academic Search Complete, Social Sciences Citation Index, CINAHL Plus, APA PsycInfo, MEDLINE, Scopus and ScienceDirect were searched to find eligible RCTs assessing the effectiveness of HL interventions on COPD self-management outcomes in outpatient settings between 2008 and February 2020. Ten RCTs met the eligibility criteria. The review found that HL interventions led to moderate improvements in physical activity levels (four out of seven trials) and COPD knowledge (three out of six trials). Surprisingly, none of the RCTs led to significant improvement in medication adherence, which warrants further studies. Furthermore, there were inconclusive findings regarding other COPD self-management outcomes such as smoking cessation, medication adherence, dyspnea, mental health, hospital admissions and health related quality of life.
慢性阻塞性肺疾病（COPD）是一种慢性进行性肺部疾病，给社会带来了巨大的健康和经济负担。自我管理对 COPD 的控制和管理有益，健康素养（HL）是 COPD 自我管理的主要驱动力。本综述旨在总结使用随机对照试验（RCT）评估 HL 驱动的 COPD 自我管理干预措施的最新有效性证据。为了寻找评估 HL 干预措施对门诊环境中 COPD 自我管理结局的有效性的合格 RCT，我们在 2008 年至 2020 年 2 月间检索了八个数据库，包括科学引文索引、学术综合搜索、社会科学引文索引、CINAHL Plus、APA PsycInfo、MEDLINE、Scopus 和 ScienceDirect。有 10 项 RCT 符合纳入标准。本综述发现，HL 干预措施可使体力活动水平（7 项试验中的 4 项）和 COPD 知识（6 项试验中的 3 项）适度改善。令人惊讶的是，没有 RCT 导致药物依从性的显著改善，这需要进一步的研究。此外，其他 COPD 自我管理结局如戒烟、药物依从性、呼吸困难、心理健康、住院和健康相关生活质量的结果尚无定论。
