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Which behaviour change techniques are most effective in improving healthcare utilisation in COPD self-management programmes? A protocol for a systematic review
  1. Katelyn Rene Smalley,
  2. Lisa Aufegger,
  3. Kelsey Flott,
  4. Gracie Holt,
  5. Erik K Mayer and
  6. Ara Darzi
  1. Surgery and Cancer, Imperial College London, London, UK
  1. Correspondence to Dr Katelyn Rene Smalley; k.smalley17{at}


Introduction Self-management interventions are often presented as a way to improve the quality of care for patients with chronic illness. However, self-management is quite broadly defined and it remains unclear which types of interventions are most successful. This review will use the Theoretical Domains Framework (TDF) as a lens through which to categorise self-management interventions regarding which programmes are most likely to be effective and under which circumstances.

The aim of this study is to (1) describe the types of self-management programmes that have been developed in chronic obstructive pulmonary disease (COPD) and identify the common elements between these to better classify self-management, and (2) evaluate the effect that self-management programmes have on the healthcare behaviour of patients with COPD by classifying those programmes by the behaviour change techniques used.

Methods and analysis A systematic search of the literature will be performed in MEDLINE, EMBASE, HMIC and PsycINFO. This review will be limited to randomised controlled trials and quasi-experimental studies. The review will follow PRISMA-P guidelines, and will provide a PRISMA checklist and flowchart. Risk of bias in individual studies will be assessed using the Cochrane Risk of Bias criteria, and the quality of included studies will be evaluated using the GRADE criteria, and will be reported in a Summary of Findings table.

The primary analysis will be a catalogue of the interventions based on the components of the TDF that were used in the intervention. A matrix comparing included behaviour change techniques to improvements in utilisation will summarise the primary outcomes.

Ethics and dissemination Not applicable, as this is a secondary review of the literature.

Prospero registration number CRD42018104753.

  • chronic disease
  • health knowledge
  • attitudes
  • practice
  • patient participation
  • personal autonomy
  • self-assessment
  • health literacy
  • health behaviour
  • health promotion
  • risk reduction behaviour
  • motivation
  • problem solving
  • decision making
  • self administration
  • disease management

This is an open access article distributed in accordance with the Creative Commons Attribution 4.0 Unported (CC BY 4.0) license, which permits others to copy, redistribute, remix, transform and build upon this work for any purpose, provided the original work is properly cited, a link to the licence is given, and indication of whether changes were made. See:

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  • Contributors KRS, EM and KF conceptualised this research. KRS designed the protocol. KRS, EM and KF defined the concepts and search items. EM, KF, LA and AD contributed to the conceptualisation and commented on the protocol. Study selection, screening and data extraction will be completed by KRS, GH and LA. The manuscript was written by KRS with contributions from all authors.

  • Funding This work is supported by the National Institute for Health Research (NIHR) Imperial Patient SafetyTranslation Research Centre (PSTRC), and infrastructure support was provided by the NIHR Imperial Biomedical Research Centre (BRC). The views of the authors donot necessarily reflect those of the NHS, NIHR or the Department of Health.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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