A Cochrane review [Abstract] 1 included 9 studies on home visits from nurses for people with chronic obstructive pulmonary disease (COPD), with a total of 1 498 subjects. There was a non-significant reduction in mortality at 12 months (OR 0.72, 95% CI 0.45 to 1.15; 8 studies). Disease-specific health-related quality of life (HRQL) was statistically significantly improved (mean difference -2.61, 95% CI -4.82 to -0.40; 4 studies). There seemed to be no statistically significant difference in the number of hospitalisations (OR 1.01, 95% CI 0.71 to 1.44; 5 studies), but there was significant heterogeneity between the studies. One outlying study showed a statistically significant decrease in hospitalisations in patients receiving home care, whereas the other studies showed a non-significant increase in hospitalisations.
Comment: The quality of evidence is downgraded by limitations in study quality (inadequate or unclear allocation concealment. lack of blinding) and byinconsistency (variability in results across studies, heterogeneity in interventions and outcomes).
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