Self-management programmes for adult patients with bronchiectasis: a systematic review and realist synthesis

Tsang, Anthony ORCID: https://orcid.org/0000-0002-2735-7515, Lynes, Dave, McKenzie, Hayley, Spencer, Sally and Kelly, Carol (2022) Self-management programmes for adult patients with bronchiectasis: a systematic review and realist synthesis. Disability and Rehabilitation, 44 (23). pp. 6939-6948. ISSN 0963-8288

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Abstract

Purpose: Self-management for bronchiectasis patients has been identified as an important component that could potentially empower patients to manage their conditions and improve quality of life. Evidence was reviewed to investigate what self-management programmes work, why and in what circumstances. Methods: A comprehensive database search was conducted on seven databases for evidence published up to June 2020. Self-management programmes were examined in each study and had to include at least two of the following selfmanagement interventions: education, exercise, adherence to treatment, symptom monitoring, airway clearance techniques (ACT) and action plans. A realist logic of analysis was applied to produce context-mechanism-outcome configurations to provide an explanatory account of which self-management intervention programmes works, for whom and in what circumstances. Results: Seven eligible articles (n = 273) contributed to the development of three context-mechanism-outcome configurations articulated for three self-management programmes that included education and action planning, education and ACT, and education, exercise and ACT. Provision of resources, knowledge, patient empowerment, self-regulation and social facilitation can improve self-efficacy, healthrelated quality of life and exercise capacity in different contexts. Conclusions: The findings of this review has identified potentially important underlying processes that contribute to the short-term increase of clinical outcomes in different contexts.