149 6 Cochrane review on integrated disease management for COPD Why it is important to do this review Review authors undertook the original version of this Cochrane Review in 2013 following a number of other (systematic) reviews that described bene cial e ects of IDM for the health status of patients with COPD but were unable to draw rm conclusions due to large heterogeneity among interventions, study populations, outcome measurements, and methodological quality. This original review included 26 studies (Kruis 2013), and review authors concluded that IDM improved diseasespeci c QoL and exercise capacity while reducing hospital admissions and hospital days per person. An update of the review is required because since that time, many new studies have been conducted to evaluate the e ects of IDM programmes on quality of life, exercise capacity, lung function, and exacerbation-related outcomes such as respiratory-related hospital admissions and emergency department (ED) visits. Also, COPD care globally has advanced tremendously. Advancements include greater nancial reimbursement for pulmonary rehabilitation programmes and use of technological and digital opportunities. These have altered and potentially improved usual care and have resulted in new studies on the e ectiveness of di erent types of IDM programmes, including telemonitoring interventions. Furthermore, the introduction of telemonitoring has allowed better assessment of actual adherence to IDM programmes due to logging of data entry in apps. This has reinforced the importance of long-term follow-up of outcomes, given that rates of adherence to the IDM programme vary widely and subsequently observed e ects can be short-lived (Cheikh-Moussa 2020; Herbert 2018). Finally, the studies included in the previous review provided insu cient data to permit rm conclusions about the longterm e ectiveness of IDM. In summary, in this update of the review, we aimed to summarise and assess evidence of short-, medium-, and long-term e ectiveness of IDM compared to usual care among patients with COPD. Objectives To compare the e ectiveness of integrated disease management (IDM) programmes versus usual care for people with chronic obstructive pulmonary disease (COPD) in terms of health-related quality of life (QoL), exercise tolerance, and exacerbationrelated outcomes.
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