Effectiveness of self-management digital interventions in improving health-related outcomes in patients with chronic obstructive pulmonary disease: An umbrella review

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality. Self-management interventions improve health outcomes but suffer from limited accessibility and sustainability. The usage of digital interventions may offer scalable alternatives. RESEARCH QUESTION: What is the effectiveness of self-management digital interventions in improving health-related outcomes among adults with COPD? METHODS: This umbrella review followed the JBI methodology and was registered in PROSPERO (CRD42024517476). A systematic search across multiple databases was conducted to identify relevant systematic reviews published in any language from database inception to February 2024. Effect sizes and confidence intervals reported in the included reviews were converted into equivalent odds ratios (eORs) to enable standardised comparisons across outcomes. RESULTS: Thirteen systematic reviews (15 363 participants) were included, of which 11 reported meta-analyses and two provided narrative syntheses only. Self-management digital interventions improved physical activity (eOR 2·34 [95% CI 1·14-4·80]), quality of life (eOR 2·02 [1·41-2·90]), lung function (eOR 2·60 [1·04-6·50]), adherence (eOR 5·04 [2·14-11·87]), anxiety (eOR 1·43 [1·15-1·76]), and depression (eOR 1·30 [1·05-1·60]). Effects were inconclusive for dyspnoea, physical capacity, sedentary time, emergency visits, and mortality. Heterogeneity was substantial across most outcomes. The certainty of evidence according to the GRADE approach ranged from very low to moderate. CONCLUSION: Self-management digital interventions appear effective in improving several key outcomes in COPD management. Future research should prioritise standardised methodologies and long-term evaluations to strengthen the evidence base.