The effectiveness of self-management support interventions for men with long-term conditions: a systematic review and meta-analysis

Paul Galdas, Jennifer Fell, Peter Bower, Lisa Kidd, Christian Blickem, Kerri McPherson, Kate Hunt, Simon Gilbody, Gerry Richardson, Paul Galdas, Jennifer Fell, Peter Bower, Lisa Kidd, Christian Blickem, Kerri McPherson, Kate Hunt, Simon Gilbody, Gerry Richardson

Abstract

Objectives: To assess the effectiveness of self-management support interventions in men with long-term conditions.

Methods: A quantitative systematic review with meta-analysis.

Data sources: The Cochrane Database of Systematic Reviews was searched to identify published reviews of self-management support interventions. Relevant reviews were screened to identify randomised controlled trials (RCTs) of self-management support interventions conducted in men alone, or which analysed the effects of interventions by sex.

Review methods: Data on relevant outcomes, patient populations, intervention type and study quality were extracted. Quality appraisal was conducted using the Cochrane Risk of Bias Tool. Meta-analysis was conducted to compare the effects of interventions in men, women, and mixed-sex sub-groups.

Results: 40 RCTs of self-management support interventions in men, and 20 eligible RCTs where an analysis by sex was reported, were included in the review. Meta-analysis suggested that physical activity, education, and peer support-based interventions have a positive impact on quality of life in men. However, there is currently insufficient evidence to make strong statements about whether self-management support interventions show larger, similar or smaller effects in men compared with women and mixed-sex groups.

Conclusions: Clinicians may wish to consider whether certain types of self-management support (eg, physical activity, education, peer support) are particularly effective in men, although more research is needed to fully determine and explore this.

Keywords: PRIMARY CARE; PUBLIC HEALTH.

Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

Figures

Figure 1
Figure 1
Analysis #2 (HCP, healthcare professionals; RCT, randomised controlled trial).
Figure 2
Figure 2
Analysis #3 (RCT, randomised controlled trial).
Figure 3
Figure 3
Exclusion of criteria and paper selection flow chart (LCT, long-term condition; RCT, randomised controlled trial).
Figure 4
Figure 4
Summary of Cochrane risk of bias for male-only trials.

References

    1. Department of Health. Improving chronic disease management. London: Department of Health, 2004.
    1. Department of Health. Long term conditions compendium of information. 3rd edn. London: Department of Health, 2012.
    1. Coutler A, Roberts S, Dixon A. Delivering better services for people with long-term conditions. Building the house of care. London: The King's Fund, 2013.
    1. NHS Networks. (accessed 7 Feb 2014).
    1. Department of Health. The Mandate. A mandate from the Government to the NHS Commissioning Board: April 2013 to March 2015. 2013. (accessed 7 Feb 2014).
    1. Department of Health. Self-care: a real choice. London: Department of Health, 2005.
    1. Panagioti M, Richardson G, Murray E et al. . Reducing Care Utilisation through Self-management Interventions (RECURSIVE): a systematic review and meta-analysis. Health Serv Deliv Res 2014. Published Online Dec 2014. doi:10.3310/hsdr02540
    1. Furler J, Harris M, Rogers A. Equity and long-term condition self-management. Chronic illness 2011;7:3–5. 10.1177/1742395310386978
    1. Kennedy A, Bower P, Reeves D et al. . Implementation of self management support for long term conditions in routine primary care settings: cluster randomised controlled trial. BMJ 2013;346 10.1136/bmj.f2882
    1. Chodosh J, Morton SC, Mojica W et al. . Meta-analysis: chronic disease self-management programs for older adults. Ann Intern Med 2005;143:427–38. 10.7326/0003-4819-143-6-200509200-00007
    1. White A, McKee M, Richardson N et al. . Europe's men need their own health strategy. BMJ 2011;343:d7397Z–0. 10.1136/bmj.d7397
    1. European Commission. The state of men's health in Europe report. European Union, 2011.
    1. Lorig KR, Ritter P, Stewart AL et al. . Chronic disease self-management program: 2-year health status and health care utilization outcomes. Med Care 2001;39:1217 10.1097/00005650-200111000-00008
    1. Foster G, Taylor S, Eldridge S et al. . Self-management education programmes by lay leaders for people with chronic conditions. Cochrane Database Syst Rev 2007;(4):CD005108.
    1. Kennedy A, Reeves D, Bower P et al. . The effectiveness and cost effectiveness of a national lay-led self care support programme for patients with long-term conditions: a pragmatic randomised controlled trial. J Epidemiol Community Health 2007;61:254–61. 10.1136/jech.2006.053538
    1. Bury M, Newbould J, Taylor D. A rapid review of the current state of knowledge regarding lay led self management of chronic illness: evidence review. London: National Institute for Health and Clinical Excellence, 2005.
    1. Banks I. No man's land: men, illness and the NHS. BMJ 2001;323:1058–60. 10.1136/bmj.323.7320.1058
    1. Galdas PM, Cheater F, Marshall P. Men and health help-seeking behaviour: literature review. J Adv Nurs 2005;49:616–23. 10.1111/j.1365-2648.2004.03331.x
    1. Courtenay WH. Key determinants of the health and well-being of men and boys. Int J Mens Health 2003;2:1–30. 10.3149/jmh.0201.1
    1. O'Brien R, Hunt K, Hart G. ‘It's caveman stuff, but that is to a certain extent how guys still operate’: men's accounts of masculinity and help-seeking. Soc Sci Med 2005;61:503–16. 10.1016/j.socscimed.2004.12.008
    1. McCartney G, Mahmood L, Leyland AH et al. . Contribution of smoking-related and alcohol-related deaths to the gender gap in mortality: evidence from 30 European countries. Tob Control 2011;20:166–8. 10.1136/tc.2010.037929
    1. Wilkins D, Payne S, Granville G et al. . The gender and access to health services study: final report. London: Department of Health, 2008.
    1. Galdas P, Darwin Z, Kidd L et al. . The accessibility and acceptability of self-management support interventions for men with long term conditions: a systematic review and meta-synthesis of qualitative studies. BMC Public Health 2014;14:1230 10.1186/1471-2458-14-1230
    1. Taylor S, Pinnock H, Epiphanou E et al. . A rapid synthesis of the evidence on interventions supporting self-management for people with long-term conditions: PRISMS—Practical systematic Review of Self-Management Support for long-term conditions. Health Serv Deliv Res 2014. Published Online Dec 2014. doi:10.3310/hsdr02530
    1. Pincus T, Miles C, Froud R et al. . Methodological criteria for the assessment of moderators in systematic reviews of randomised controlled trials: a consensus study. BMC Med Res Methodol 2011;11:14 10.1186/1471-2288-11-14
    1. Sun X, Briel M, Busse JW et al. . Credibility of claims of subgroup effects in randomised controlled trials: systematic review. BMJ 2012;344:e1553 10.1136/bmj.e1553
    1. Chandwani KD, Thornton B, Perkins GH et al. . Yoga improves quality of life and benefit finding in women undergoing radiotherapy for breast cancer. J Soc Integr Oncol 2010;8:43–55.
    1. Higgins JP, Thompson SG, Deeks JJ et al. . Measuring inconsistency in meta-analyses. BMJ 2003;327:557–60. 10.1136/bmj.327.7414.557
    1. Adamsen L, Quist M, Andersen C et al. . Effect of a multimodal high intensity exercise intervention in cancer patients undergoing chemotherapy: randomised controlled trial. BMJ 2009;339:b3410 10.1136/bmj.b3410
    1. Banerjee B, Vadiraj HS, Ram A et al. . Effects of an integrated yoga program in modulating psychological stress and radiation-induced genotoxic stress in breast cancer patients undergoing radiotherapy. Integr Cancer Ther 2007;6:242–50. 10.1177/1534735407306214
    1. Bennett JA, Lyons KS, Winters-Stone K et al. . Motivational interviewing to increase physical activity in long-term cancer survivors: a randomized controlled trial. Nurs Res 2007;56:18–27. 10.1097/00006199-200701000-00003
    1. Cadmus LA, Salovey P, Yu H et al. . Exercise and quality of life during and after treatment for breast cancer: results of two randomized controlled trials. Psychooncology 2009;18:343–52. 10.1002/pon.1525
    1. Carmack CAM, Boudreaux M, Brantley E et al. . Exercise as a component in the physical and psychological rehabilitation of hemodialysis patients. Int J Rehabil Health 1995;1:13–23. 10.1007/BF02214958
    1. Cheville AL, Girardi J, Clark MM et al. . Therapeutic exercise during outpatient radiation therapy for advanced cancer: feasibility and impact on physical well-being. Am J Phys Med Rehabil 2010;89:611–19. 10.1097/PHM.0b013e3181d3e782
    1. Cohen L, Warneke C, Fouladi RT et al. . Psychological adjustment and sleep quality in a randomized trial of the effects of a Tibetan yoga intervention in patients with lymphoma. Cancer 2004;100:2253–60. 10.1002/cncr.20236
    1. Coultas D, Frederick J, Barnett B et al. . A randomized trial of two types of nurse-assisted home care for patients with COPD. Chest 2005;128:2017–24. 10.1378/chest.128.4.2017
    1. Courneya KS, Friedenreich CM, Quinney HA et al. . A randomized trial of exercise and quality of life in colorectal cancer survivors. Eur J Cancer Care (Engl) 2003;12:347–57. 10.1046/j.1365-2354.2003.00437.x
    1. Courneya KS, Friedenreich CM, Sela RA et al. . The group psychotherapy and home-based physical exercise (group-hope) trial in cancer survivors: physical fitness and quality of life outcomes. Psychooncology 2003;12:357–74. 10.1002/pon.658
    1. Danhauer SC, Mihalko SL, Russell GB et al. . Restorative yoga for women with breast cancer: findings from a randomized pilot study. Psychooncology 2009;18:360–8. 10.1002/pon.1503
    1. Demark-Wahnefried W, Clipp EC, Morey MC et al. . Lifestyle intervention development study to improve physical function in older adults with cancer: outcomes from Project LEAD. J Clin Oncol 2006;24:3465–73. 10.1200/JCO.2006.05.7224
    1. Donnelly CM, Blaney JM, Lowe-Strong A et al. . A randomised controlled trial testing the feasibility and efficacy of a physical activity behavioural change intervention in managing fatigue with gynaecological cancer survivors. Gynecol Oncol 2011;122:618–24. 10.1016/j.ygyno.2011.05.029
    1. Emery CF, Schein RL, Hauck ER et al. . Psychological and cognitive outcomes of a randomized trial of exercise among patients with chronic obstructive pulmonary disease. Health Psychol 1998;17:232–40. 10.1037/0278-6133.17.3.232
    1. Fillion L, Gagnon P, Leblond F et al. . A brief intervention for fatigue management in breast cancer survivors. Cancer Nurs 2008;31:145–59. 10.1097/01.NCC.0000305698.97625.95
    1. Heckman TG, Carlson B. A randomized clinical trial of two telephone-delivered, mental health interventions for HIV-infected persons in rural areas of the United States. AIDS Behav 2007;11:5–14. 10.1007/s10461-006-9111-9
    1. Jarden M, Baadsgaard MT, Hovgaard DJ et al. . A randomized trial on the effect of a multimodal intervention on physical capacity, functional performance and quality of life in adult patients undergoing allogeneic SCT. Bone Marrow Transplant 2009;43:725–37. 10.1038/bmt.2009.27
    1. Johansson B, Brandberg Y, Hellbom M et al. . Health-related quality of life and distress in cancer patients: results from a large randomised study. Br J Cancer 2008;99:1975–83. 10.1038/sj.bjc.6604789
    1. Kouidi E, Iacovides A, Iordanidis P et al. . Exercise renal rehabilitation program: psychosocial effects. Nephron 1997;77:152–8. 10.1159/000190266
    1. Dominique LG, Annelie D, Madan A et al. . Impact of the yoga Bali method on quality of life and depressive symptoms among women diagnosed with breast cancer undergoing chemotherapy. Psychooncology 2010;19(Supp 2):S136–40.
    1. Moadel AB, Shah C, Wylie-Rosett J et al. . Randomized controlled trial of yoga among a multiethnic sample of breast cancer patients: effects on quality of life. J Clin Oncol 2007;25:4387–95. 10.1200/JCO.2006.06.6027
    1. Mock V, Frangakis C, Davidson NE et al. . Exercise manages fatigue during breast cancer treatment: a randomized controlled trial. Psychooncology 2005;14:464–77. 10.1002/pon.863
    1. Mutrie N, Campbell AM, Whyte F et al. . Benefits of supervised group exercise programme for women being treated for early stage breast cancer: pragmatic randomised controlled trial. BMJ 2007;334:517 10.1136/
    1. Pinto BM, Frierson GM, Rabin C et al. . Home-based physical activity intervention for breast cancer patients. J Clin Oncol 2005;23:3577–87. 10.1200/JCO.2005.03.080
    1. Puig AL, Goodwin SM, Sherrard L et al. . The efficacy of creative arts therapies to enhance emotional expression, spirituality, and psychological well-being of newly diagnosed Stage I and Stage II breast cancer patients: a preliminary study. Arts Psychother 2006;33:218–28.
    1. Raghavendra RM, Nagarathna R, Nagendra HR et al. . Effects of an integrated yoga programme on chemotherapy-induced nausea and emesis in breast cancer patients. Eur J Cancer Care (Engl) 2007;16:462–74. 10.1111/j.1365-2354.2006.00739.x
    1. Rogers LQ, Hopkins-Price P, Vicari S et al. . A randomized trial to increase physical activity in breast cancer survivors. Med Sci Sports Exerc 2009;41:935–46. 10.1249/MSS.0b013e31818e0e1b
    1. Stein MD, Herman DS, Bishop D et al. . A telephone-based intervention for depression in HIV patients: negative results from a randomized clinical trial. AIDS Behav 2007;11:15–23. 10.1007/s10461-006-9131-5
    1. Thorsen L, Skovlund E, Stromme SB et al. . Effectiveness of physical activity on cardiorespiratory fitness and health-related quality of life in young and middle-aged cancer patients shortly after chemotherapy. J Clin Oncol 2005;23:2378–88. 10.1200/JCO.2005.04.106
    1. van Vilsteren MC, de Greef MH, Huisman RM. The effects of a low-to-moderate intensity pre-conditioning exercise programme linked with exercise counselling for sedentary haemodialysis patients in The Netherlands: results of a randomized clinical trial. Nephrol Dial Transplant 2005;20:141–6. 10.1093/ndt/gfh560
    1. Wang YJ, Boehmke M, Wu YW et al. . Effects of a 6-week walking program on Taiwanese women newly diagnosed with early-stage breast cancer. Cancer Nurs 2011;34:E1–13. 10.1097/NCC.0b013e3181e4588d
    1. Pawson R, Greenhalgh T, Harvey G et al. . Realist review—a new method of systematic review designed for complex policy interventions. J Health Serv Res Policy 2005;10(suppl 1):21–34. 10.1258/1355819054308530
    1. Bower P, Kontopantelis E, Sutton A et al. . Influence of initial severity of depression on effectiveness of low intensity interventions: meta-analysis of individual patient data. BMJ 2012;346:f540 10.1136/bmj.f540
    1. Michie S, West R. Behaviour change theory and evidence: a presentation to government. Health Psychol Rev 2013;7:1–22. 10.1080/17437199.2012.654964

Source: PubMed

Sponsors en medewerkers

Medische omstandigheden

Geneesmiddelinterventies

3
Abonneren