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Hindelang, M. ; Kirsch, F. ; Leidl, R.

Effectiveness of non-pharmacological COPD management on health-related quality of life-a systematic review.

Expert Rev. Pharmacoecon. Outcomes Res. 20, 79-91 (2020)

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Introduction: Chronic obstructive pulmonary disease (COPD) is the third leading cause of mortality worldwide. The chronic progressive disease is accompanied by a high loss of health-related quality of life (HRQoL). The available drugs usually only have symptomatic effects; therefore, non-pharmacological therapies are essential too. Areas covered: This systematic review examines non-pharmacological interventions consisting of pulmonary rehabilitation, physical activity, and training versus usual care or no intervention in COPD using at least one of the following HRQoL measuring instruments: St. George's Respiratory Questionnaire, Clinical COPD Questionnaire, COPD Assessment Test, and EuroQol-5D. Of 1532 identified records from CENTRAL, MEDLINE, and EMBASE, 15 randomized controlled trials met the inclusion criteria. Pulmonary rehabilitation programs were investigated in nine studies, education and counseling-based training programs in three studies, and breathing exercises in three studies. Ten studies were found that investigated non-pharmacological treatment programs that led to a significant and clinically relevant improvement in HRQoL compared with usual care or no treatment. Expert opinion: Non-pharmacological interventions consisting of pulmonary rehabilitation, education and counseling-based training programs, and breathing exercises can improve the HRQoL of COPD patients.

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