TY - JOUR
AU - X. Guan
AU - Y. Xia
AU - J. Ai
AU - Z. Shi
AU - X. Wei
AU - P. He
A1 - 
AB - BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a leading global health burden, with high prevalence of comorbidities (e.g., hypertension and diabetes) that further increase healthcare utilization and mortality. Integrated care is proposed as a potential management strategy for COPD patients with comorbidities, but its overall effects remain unclear due to inconsistent evidence from prior studies. OBJECTIVES: To systematically evaluate the effects of integrated care on key health outcomes in patients with COPD and at least one comorbidity. DESIGN: Systematic review and meta-analysis. DATA SOURCES AND METHODS: Databases including MEDLINE, EMBASE, CENTRAL, CINAHL, and ClinicalTrial.gov were searched. Eligible studies were randomized controlled trials (RCTs) evaluating integrated care in patients with COPD and comorbidities. Two independent reviewers conducted study screening, data extraction, and quality assessment. Effects of integrated care were assessed using a random-effects model. RESULTS: Seven RCTs from high-income countries were included. Common integrated care components were health education, self-management support, and (in two studies) telemonitoring. Meta-analysis showed that integrated care significantly reduced the number of COPD exacerbations and all-cause hospitalizations. No significant effects were observed for all-cause emergency visits or CAT scores. CONCLUSION: Integrated care effectively reduces COPD exacerbations and all-cause hospitalizations in patients with COPD and comorbidities, supporting its clinical value. However, high heterogeneity across studies, limited generalizability to non-high-income countries (e.g., China), and lack of impact on patient-reported outcomes (CAT scores) highlight the need for further localized research. TRIAL REGISTRATION: Registered with PROSPERO, Registration ID: CRD420251170533.; COPD and comorbidities: the effects of integrated careChronic obstructive pulmonary disease (COPD), a serious lung condition affecting millions worldwide, often occurs alongside other health problems (e.g., heart disease, diabetes). These additional conditions can worsen outcomes, increasing hospital stays and even death. While “integrated care” (combining treatments, education, and long-term support) is often recommended for such patients, its benefits need clearer evidence. This study reviewed seven high-quality clinical trials from wealthier countries to evaluate how integrated care affects COPD patients with other health issues. Most programs included education, self-management training, and remote health monitoring. Key findings: Integrated care reduced sudden worsening of COPD symptoms (“exacerbations”). It also lowered the chance of being hospitalized for any health reason. However, it did not significantly reduce emergency room visits or improve patients’ self-reported symptom scores (CAT scores). These results suggest that integrated care can help stabilize COPD patients and reduce hospital stays, making it a valuable approach for healthcare systems. However, more research is needed to adapt these programs for low-income regions and to improve their impact on quality of life.; eng
AD - China Center for Health Development Studies, Peking University, Beijing, China.; China Center for Health Development Studies, Peking University, XueYuan Rd 38, Mailbox 505, Haidian District, Beijing 100191, China.
AN - 41553852
BT - Ther Adv Respir Dis
C5 - Healthcare Disparities
DA - Jan-Dec
DO - 10.1177/17534666251414315
DP - NLM
ET - 20260119
JF - Ther Adv Respir Dis
LA - eng
N2 - BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a leading global health burden, with high prevalence of comorbidities (e.g., hypertension and diabetes) that further increase healthcare utilization and mortality. Integrated care is proposed as a potential management strategy for COPD patients with comorbidities, but its overall effects remain unclear due to inconsistent evidence from prior studies. OBJECTIVES: To systematically evaluate the effects of integrated care on key health outcomes in patients with COPD and at least one comorbidity. DESIGN: Systematic review and meta-analysis. DATA SOURCES AND METHODS: Databases including MEDLINE, EMBASE, CENTRAL, CINAHL, and ClinicalTrial.gov were searched. Eligible studies were randomized controlled trials (RCTs) evaluating integrated care in patients with COPD and comorbidities. Two independent reviewers conducted study screening, data extraction, and quality assessment. Effects of integrated care were assessed using a random-effects model. RESULTS: Seven RCTs from high-income countries were included. Common integrated care components were health education, self-management support, and (in two studies) telemonitoring. Meta-analysis showed that integrated care significantly reduced the number of COPD exacerbations and all-cause hospitalizations. No significant effects were observed for all-cause emergency visits or CAT scores. CONCLUSION: Integrated care effectively reduces COPD exacerbations and all-cause hospitalizations in patients with COPD and comorbidities, supporting its clinical value. However, high heterogeneity across studies, limited generalizability to non-high-income countries (e.g., China), and lack of impact on patient-reported outcomes (CAT scores) highlight the need for further localized research. TRIAL REGISTRATION: Registered with PROSPERO, Registration ID: CRD420251170533.; COPD and comorbidities: the effects of integrated careChronic obstructive pulmonary disease (COPD), a serious lung condition affecting millions worldwide, often occurs alongside other health problems (e.g., heart disease, diabetes). These additional conditions can worsen outcomes, increasing hospital stays and even death. While “integrated care” (combining treatments, education, and long-term support) is often recommended for such patients, its benefits need clearer evidence. This study reviewed seven high-quality clinical trials from wealthier countries to evaluate how integrated care affects COPD patients with other health issues. Most programs included education, self-management training, and remote health monitoring. Key findings: Integrated care reduced sudden worsening of COPD symptoms (“exacerbations”). It also lowered the chance of being hospitalized for any health reason. However, it did not significantly reduce emergency room visits or improve patients’ self-reported symptom scores (CAT scores). These results suggest that integrated care can help stabilize COPD patients and reduce hospital stays, making it a valuable approach for healthcare systems. However, more research is needed to adapt these programs for low-income regions and to improve their impact on quality of life.; eng
PY - 2026
SN - 1753-4658 (Print); 1753-4658
SP - 17534666251414315
ST - Effects of integrated care on patients with COPD and comorbidities: a systematic review
T1 - Effects of integrated care on patients with COPD and comorbidities: a systematic review
T2 - Ther Adv Respir Dis
TI - Effects of integrated care on patients with COPD and comorbidities: a systematic review
U1 - Healthcare Disparities
U3 - 10.1177/17534666251414315
VL - 20
VO - 1753-4658 (Print); 1753-4658
Y1 - 2026
ER -