The Crux of Self-Management
Self-management is a cornerstone in chronic disease management, offering patients the reins to control their health journey. In pulmonary fibrosis, a condition fraught with complexities, self-management becomes a lighthouse guiding patients through the fog of their ailment.
The Source Article Details
Self-management interventions for people with pulmonary fibrosis: a scoping review. by Joanna Y T Lee et al. in 2023.
The Source Article's Abstract
The most effective method for encouraging self-management in individuals with pulmonary fibrosis (PF) is unclear. This review aimed to identify common self-management components, the outcome measures used and the impact of these components in PF.
A scoping review was conducted according to the Joanna Briggs Institute Manual for Evidence Synthesis using Medline, Embase, PsychInfo, CINAHL and the Cochrane Central Register of Controlled Trials. Eligible studies included those with educational, behavioural or support components aimed at facilitating self-management among adults with PF and employed quantitative and/or qualitative methods.
87 studies were included. Common self-management components included education (78%), managing physical symptoms (66%) and enhancing psychosocial wellbeing (54%). Components were predominantly delivered in a pulmonary rehabilitation setting (71%). No studies tested a PF-specific self-management package. Common outcome measures were 6-min walk distance (60%), St George's Respiratory Questionnaire (37%) and the Medical Research Council Dyspnoea scale (34%). Clinically significant improvements in these outcomes were seen in ≥50% of randomised controlled trials. Qualitative data highlighted the importance of healthcare professional and peer support and increased confidence in managing PF.
Self-management components are commonly incorporated into pulmonary rehabilitation programmes rather than being offered as standalone packages. Future research should focus on testing PF-specific self-management packages and employ standardised outcome assessments that include self-efficacy and health-related behaviours.
The Source Article References
- Pulmonary rehabilitation for interstitial lung disease by Dowman, 2021 in Cochrane Database Syst Rev
- Comprehensive pulmonary rehabilitation for interstitial lung disease: a consensus approach to identify core education topics by Holland, 2019 in Patient Educ Couns
- The unmet educational needs of patients with interstitial lung disease: setting the stage for tailored pulmonary rehabilitation by Morisset, 2016 in Ann Am Thorac Soc
- Self-management education and regular practitioner review for adults with asthma by Gibson, 2003 in Cochrane Database Syst Rev
- Self-management interventions for people with chronic obstructive pulmonary disease by Schrijver, 2022 in Cochrane Database Syst Rev
- Identifying components of self-management interventions that improve health-related quality of life in chronically ill patients: systematic review and meta-regression analysis by Jonkman, 2016 in Patient Educ Couns
- Self-management for pulmonary fibrosis: insights from people living with the disease and healthcare professionals by Lee, 2022 in Patient Educ Couns
- Impact of a pulmonary rehabilitation programme on respiratory parameters and health care utilization in patients with chronic lung diseases other than COPD by Al Moamary, 2012 in East Mediterr Health J
- Seeking and sharing: why the pulmonary fibrosis community engages the web 2.0 environment by Albright, 2016 in BMC Pulm Med
- Early integrated palliative care bundle impacts location of death in interstitial lung disease: a pilot retrospective study by Archibald, 2021 in Am J Hosp Palliat Care
- Pulmonary rehabilitation in patients with idiopathic pulmonary fibrosis: comparison with chronic obstructive pulmonary disease by Arizono, 2017 in Sarcoidosis Vasc Diffuse Lung Dis
- Better together: a mixed-methods study of palliative care co-management for patients with interstitial lung disease by Bischoff, 2021 in J Palliat Med
- Pulmonary rehabilitation in patients with interstitial lung diseases: correlates of success by Brunetti, 2021 in Respir Med
- Tele-rehabilitation program in idiopathic pulmonary fibrosis – a single-center randomized trial by Cerdán-de-las-Heras, 2021 in Int J Environ Res Public Health
- Impact of palliative care in end-of-life of fibrotic interstitial lung disease patients by Chai, 2022 in Am J Hosp Palliat Care
- Cardiorespiratory adaptation during 6-minute walk test in fibrotic idiopathic interstitial pneumonia patients who did or did not respond to pulmonary rehabilitation by Chéhère, 2019 in Eur J Phys Rehabil Med
- Pulmonary rehabilitation in patients with advanced idiopathic pulmonary fibrosis referred for lung transplantation by da Fontoura, 2018 in J Cardiopulm Rehabil Prev
- Does the severity of interstitial lung disease affect the gains from pulmonary rehabilitation? by Deniz, 2018 in Clinical Respir J
- Effect of pulmonary rehabilitation (PR) program in patients with interstitial lung disease (ILD) – Indian scenario by Devani, 2019 in J Assoc Physicians India
- Use of the patientMpower app with home-based spirometry to monitor the symptoms and impact of fibrotic lung conditions: longitudinal observational study by Edwards, 2020 in JMIR Mhealth Uhealth
Citing the Source Article (APA)
Lee, J.Y.T., Tikellis, G., Dowman, L., Jones, A.W., Hoffman, M., Mellerick, C.R., Malaguti, C., Khor, Y.H., Holland, A.E. (2023). Self-management interventions for people with pulmonary fibrosis: a scoping review.. European Respiratory Review, 32(170), 230092-230092. 10.1183/16000617.0092-2023
Pulmonary Rehabilitation: A Central Pillar
The review reveals a heavy reliance on pulmonary rehabilitation programs to impart self-management strategies. This approach, while effective, suggests a gap in PF-specific resources that could be filled with tailored self-management packages.
Outcome measures are the compass by which we navigate the success of interventions. The review highlights the most common metrics used, providing a benchmark for future research and a beacon for patients tracking their progress.
The Human Touch
Healthcare professional and peer support emerge as critical components in managing PF. This human connection fosters a supportive community, essential for the psychological well-being of patients.
A Call to Action for Future Research
The review concludes with a call for research into PF-specific self-management packages and standardized outcome assessments. This could herald a new chapter in patient empowerment and disease management.
As we explore these findings, we invite you to reflect on their implications. How do you see these insights shaping the future of patient care in pulmonary fibrosis? Join the conversation and share your thoughts below.