What do the most effective, most cost-effective and best value Integrated disease management (IDM) Programmes for people with Chronic Obstructive Pulmonary Disease (COPD) contain?
Chronic Obstructive Pulmonary Disease (COPD) is the second leading cause of hospital admission in the UK, yet no one knows which specific ingredients of integrated care programmes—such as exercise plans, self-management coaching, or medication reviews—actually drive the improvements. This project will systematically comb through decades of randomised trials, using a technique called component network meta-analysis to isolate the active components that reduce hospitalisations, flare-ups, and unscheduled GP visits while improving quality of life. The researchers will also calculate which combinations deliver the best value for the NHS. If successful, the findings could allow clinicians to strip away ineffective or costly elements from care packages, focusing resources on the handful of components that genuinely keep people with COPD out of hospital. That would mean more targeted, less burdensome care for patients and a direct reduction in the pressure on emergency departments and respiratory wards. The project is applied health services research with an immediate practical aim: to give commissioners and clinicians a clear, evidence-based recipe for the most effective and cost-effective COPD care.
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Evaluating the most effective components of Integrated Care Programmes for people with Chronic Obstructive Pulmonary Disease (COPD): A systematic review, component network meta-analysis, and economic evaluation Background: Chronic Obstructive Pulmonary Disease (COPD) is the second leading cause of hospital admission in the UK and effective care in this population has the potential for significant health and economic benefits. Integrated Care Programmes (ICP) have been shown to be effective treatments for COPD; however, we do not know which individual components of ICP’s are most effective. Review question: What do the most effective and most cost-effective Integrated Care Programmes for people with Chronic Obstructive Pulmonary Disease (COPD) contain? Methods: We will undertake a systematic review, identifying randomised controlled trials (RCT’s) on the effect of ICP’s on health related quality of life, exacerbation frequency, hospitalisation, or unscheduled healthcare usage in people with COPD. The search will include the following databases: Cochrane Central Register of Controlled Trials (CENTRAL), Cochrane Database of Systematic Reviews (CDSR), Embase (Ovid SP), MEDLINE (Ovid SP), ClinicalTrials.gov, WHO trials portal: ICTRP. We will limit to studies of adults (aged 18 years and over), studies published in peer-reviewed journals, and publications from 2005 onwards. Analysis: Qualitative constant comparison process will be used to identify and categorise components of respective interventions and control arms within studies. We will perform component network meta-analysis to establish optimal components within ICP’s. Risk of bias will be assessed using the Cochrane ROB1 tool. Involvement: Our review is supported by involvement of public and patient involvement representatives from our review PPI group and engagement with clinical interest-holders connected with providing care for people with COPD.
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