Chahdi Mohamed, Bruchhäuser Antje, von Gahlen-Hoops Wolfgang, Nydahl Peter
Gesundheits- und Krankenpfleger, Klinik für Neurologie, Station D110, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Kiel, Deutschland, Arnold-Heller-Str. 3.
Gesundheits- und Krankenpflegerin, Weaning-Station, Universitätsklinikum Schleswig-Holstein, Campus Kiel, Arnold-Heller-Str. 3, 24105, Kiel, Deutschland.
Med Klin Intensivmed Notfmed. 2023 Oct;118(7):584-591. doi: 10.1007/s00063-023-01003-0. Epub 2023 Apr 26.
Patients with chronic obstructive pulmonary disease (COPD) have a high risk of hospital and intensive care unit readmission. Readmissions are a severe burden on patients, families, and the health care system. The aim of this study is to identify pedagogical-counseling interventions to reduce readmissions and other parameters in COPD patients.
A systematic literature search was performed in March 2022 in the databases Medline, Cochrane Library, CINAHL, and LIVIVO. German‑, English‑, Arabic-, and French-language (cluster-) randomized, controlled studies were included.
In all, 21 studies with a total of 3894 COPD patients were included. The quality of included studies was moderate to good. Interventions were self-management programs, telemedical, and educational interventions. Five out of seven studies found a significant reduction in readmissions for self-management programs (p = 0.02-0.49). A positive effect of telemedicine interventions on outcome parameters was only reported in two studies (p < 0.05) and no significant effect in four studies. Educational interventions were examined in six studies: four found no difference between the study groups and two found a significant difference in favor of the intervention group (p = 0.01). Special care programs also showed a significant effect in two studies.
慢性阻塞性肺疾病（COPD）患者再次入院和入住重症监护病房的风险很高。再次入院给患者、家庭和医疗保健系统带来了沉重负担。本研究的目的是确定减少COPD患者再次入院和其他指标的教学咨询干预措施。
2022年3月在Medline、Cochrane图书馆、CINAHL和LIVIVO数据库中进行了系统的文献检索。纳入德语、英语、阿拉伯语和法语语言（整群）随机对照研究。
共纳入21项研究，总计3894例COPD患者。纳入研究的质量为中等至良好。干预措施包括自我管理项目、远程医疗和教育干预。七项研究中有五项发现自我管理项目的再次入院率显著降低（p = 0.02 - 0.49）。只有两项研究报告了远程医疗干预对结局指标有积极影响（p < 0.05），四项研究未发现显著影响。六项研究对教育干预进行了检验：四项研究发现研究组之间无差异，两项研究发现干预组有显著差异（p = 0.01）。两项研究中特殊护理项目也显示出显著效果。
