BACKGROUND: Self-management (SM) reduces hospital admissions in patients with stable chronic obstructive pulmonary disease (COPD). However, its role immediately post-acute exacerbation (AE) is unclear. The objectives of this review were to; describe SM interventions delivered immediately following an AECOPD and to conduct a systematic review with meta-analysis of its impact on healthcare utilisation and health outcomes. METHOD: Randomised controlled trials reporting on SM interventions delivered during hospitalisation for an AECOPD or within one month of hospital discharge were included. Seven papers were identified. Data were extracted and assessed for quality by two researchers. RESULTS: By definition all interventions included action plans, education and at least two SM skills. Nurses were responsible for providing all SM interventions. The delivery and follow up periods varied widely. At 12 months there were no significant differences between those who completed the SM intervention and control subjects in the number of patients readmitted to hospital (p = 0.38), or in health-related quality of life (HRQOL) (p = 0.27). No effects were found on; rate of mortality, depressive symptoms, primary care usage or exercise capacity. Minimal effects were found on; self-efficacy, anxiety symptoms, and health promoting behavior. SM was associated with positive effects on knowledge and management of an AECOPD. CONCLUSIONS: SM interventions delivered immediately post-AE vary widely and outcome measures are inconsistent, making it difficult to draw strong recommendations regarding its effectiveness. The evaluation of SM interventions, delivered by trained health care professionals to selected patients and which offer structured follow up, appears necessary.

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