AimTo determine the impact of home‐based management on hospital re‐admission rates in patients with chronic obstructive pulmonary disease (COPD).DesignSystematic review methodology was utilized, combining meta‐analysis, where appropriate, or a narrative analysis of the data from included studies.Data SourcesElectronic databases CINAHL, MEDLINE, PubMed, Embase and SAGE journals for primary papers, 2015 to 2021, were searched between December 2020 and March 2021, followed by hand‐searching key journals, and reference lists of retrieved papers.MethodsThe review followed the guidance of PRISMA. Data were extracted using a predesigned data extraction tool. Quality appraisal was undertaken using RevMan ‘risk of bias’ tool. Meta‐analysis was undertaken using RevMan software.ResultsThis review integrates evidence from eight studies, five Random Control Trials, two observational studies and one retrospective study. The studies span three continents, Asia, Europe and North America, and include 3604 participants with COPD. Home‐based management in patients with COPD resulted in a statistically significant reduction in rates of hospital readmission. For the outcomes, length of stay and mortality, while slightly in favour of home‐based management, the results were not statistically significant.ConclusionGiven the burden of COPD on healthcare systems, and crucially on individuals, this review identified a reduction in hospital re‐admission rate, a clinically important outcome.ImpactThis study focused on the impact on hospital re‐admission rates among the COPD patient cohort when home‐based management was involved. A statistically significant reduction in rates of re‐admission to the hospital was identified. This is positive for the patient, in terms of hospital avoidance, and reduces the burden on hospital systems. Further research is needed to determine the impact on cost‐effectiveness and to quantify the most ideal type of care package that would be recommended for home‐based management.

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慢性阻塞性肺病患者再入院率的家庭管理：系统评价

目的确定家庭管理对慢性阻塞性肺疾病 (COPD) 患者再入院率的影响。设计采用系统评价方法，酌情结合荟萃分析或对纳入研究的数据进行叙述性分析数据来源2020年12月至2021年3月检索​​电子数据库CINAHL、MEDLINE、PubMed、Embase和SAGE期刊2015年至2021年初级论文，然后手工检索关键期刊和检索到的论文的参考文献列表。 PRISMA 的指导。使用预先设计的数据提取工具提取数据。使用 RevMan“偏差风险”工具进行质量评估。使用 RevMan 软件进行荟萃分析。结果本综述整合了八项研究、五项随机对照试验、两项观察性研究和一项回顾性研究的证据。这些研究横跨亚洲、欧洲和北美三大洲，包括 3604 名患有慢性阻塞性肺病的参与者。慢性阻塞性肺病患者的家庭管理使再入院率在统计上显着降低。对于结果、住院时间和死亡率，虽然稍微支持家庭管理，但结果并不具有统计显着性。结论考虑到慢性阻塞性肺病对医疗保健系统的负担，尤其是对个人的负担，本次审查发现住院治疗有所减少。入院率，一个临床上重要的结果。影响本研究的重点是涉及家庭管理时对慢性阻塞性肺病患者队列的再入院率的影响。再次入院率显着降低，具有统计学意义。就避免住院而言，这对患者来说是积极的，并减轻了医院系统的负担。需要进一步的研究来确定对成本效益的影响，并量化推荐用于家庭管理的最理想的护理方案类型。