Self-management interventions for people with pulmonary fibrosis: a scoping review

Joanna Y T Lee; Gabriella Tikellis; Leona Dowman; Arwel W Jones; Mariana Hoffman; Christie R Mellerick; Carla Malaguti; Yet H Khor; Anne E Holland

doi:10.1183/16000617.0092-2023

Self-management interventions for people with pulmonary fibrosis: a scoping review

Eur Respir Rev. 2023 Nov 1;32(170):230092. doi: 10.1183/16000617.0092-2023. Print 2023 Dec 31.

Authors

Joanna Y T Lee¹, Gabriella Tikellis¹, Leona Dowman^{1

2}, Arwel W Jones¹, Mariana Hoffman^{1

3}, Christie R Mellerick^{1

4}, Carla Malaguti^{1

5}, Yet H Khor^{1

2

3

6}, Anne E Holland^{7

3

4

6}

Affiliations

¹ Respiratory Research@Alfred, Central Clinical School, Monash University, Melbourne, Australia.
² Department of Respiratory and Sleep Medicine, Austin Health, Melbourne, Australia.
³ Institute for Breathing and Sleep, Melbourne, Australia.
⁴ Department of Physiotherapy, Alfred Health, Melbourne, Australia.
⁵ Federal University of Juiz de Fora, Juiz de Fora, Brazil.
⁶ Department of Respiratory and Sleep Medicine, Alfred Health, Melbourne, Australia.
⁷ Respiratory Research@Alfred, Central Clinical School, Monash University, Melbourne, Australia a.holland@alfred.org.au.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Publication types

Review

MeSH terms

Adult
Humans
Pulmonary Disease, Chronic Obstructive* / rehabilitation
Pulmonary Fibrosis* / diagnosis
Pulmonary Fibrosis* / therapy
Quality of Life
Self Care / methods
Self-Management*