What do systematic reviews say?

Remote monitoring plus usual care vs usual care

It is very uncertain whether remote monitoring plus usual care changes time to first hospitalisation after starting intervention compared with usual care (very low certainty).

• Telehealth interventions: remote monitoring and consultations for people with chronic obstructive pulmonary disease… 2021 · Cochrane Headline outcomes only
  HR 1.08 [0.8, 1.46]
  1 study · 256 participants
  Very low

Remote monitoring plus usual care vs usual care

Remote monitoring plus usual care probably leads to lower time to first COPD‐related re‐admission compared with usual care (moderate certainty).

• Telehealth interventions: remote monitoring and consultations for people with chronic obstructive pulmonary disease… 2021 · Cochrane Headline outcomes only
  HR 0.42 [0.19, 0.93]
  1 study · 106 participants
  Moderate

Digital intervention with or without routine supported self‐management vs control

• Digital interventions for the management of chronic obstructive pulmonary disease 2021 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 122 participants
  Very low

Multi‐component intervention vs other treatments/routine care

It is very uncertain whether multi‐component intervention changes adverse events: number of people experiencing an AE compared with other intervention or routine, usual care or control treatment (very low certainty).

• Digital interventions for the management of chronic obstructive pulmonary disease 2021 · Cochrane Headline outcomes only
  OR 1.07 [0.51, 2.25]
  1 study · 166 participants
  Very low

Multi‐component intervention vs other treatments/routine care

Multi‐component intervention showed no clear difference in adverse events: number of people experiencing a serious adverse event compared with other intervention or routine, usual care or control treatment (low certainty).

• Digital interventions for the management of chronic obstructive pulmonary disease 2021 · Cochrane Headline outcomes only
  OR 0.85 [0.55, 1.34]
  1 study · 319 participants
  Low

Digital intervention with or without routine supported self‐management vs control

• Digital interventions for the management of chronic obstructive pulmonary disease 2021 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 55 participants
  Very low
• Digital interventions for the management of chronic obstructive pulmonary disease 2021 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 42 participants
  Very low

Digital intervention with or without routine supported self‐management vs control

• Digital interventions for the management of chronic obstructive pulmonary disease 2021 · Cochrane Headline outcomes only
  no estimate extracted
  2 studies · 123 participants
  Low

Digital intervention with or without routine supported self‐management vs control

• Digital interventions for the management of chronic obstructive pulmonary disease 2021 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 84 participants
  Low

Digital intervention with or without routine supported self‐management vs control

• Digital interventions for the management of chronic obstructive pulmonary disease 2021 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 69 participants
  Low

Multi‐component intervention vs other treatments/routine care

• Digital interventions for the management of chronic obstructive pulmonary disease 2021 · Cochrane Headline outcomes only
  no estimate extracted
  1 study · 20 participants
  Very low

Multi‐component intervention vs other treatments/routine care

• Digital interventions for the management of chronic obstructive pulmonary disease 2021 · Cochrane Headline outcomes only
  no estimate extracted
  3 studies · 241 participants
  Very low

Multi‐component intervention vs other treatments/routine care

It is very uncertain whether multi‐component intervention changes exacerbations: number of people experiencing at least one exacerbation compared with other intervention or routine, usual care or control treatment (very low certainty).

• Digital interventions for the management of chronic obstructive pulmonary disease 2021 · Cochrane Headline outcomes only
  OR 0.86 [0.58, 1.28]
  2 studies · 485 participants
  Very low

Phosphodiesterase 4 inhibitors vs placebo

• Phosphodiesterase‐4 inhibitors for chronic obstructive pulmonary disease 2020 · Cochrane Headline outcomes only
  no estimate extracted
  29 studies · 20815 participants
  Moderate

Phosphodiesterase 4 inhibitors vs placebo

• Phosphodiesterase‐4 inhibitors for chronic obstructive pulmonary disease 2020 · Cochrane Headline outcomes only
  no estimate extracted
  17 studies · 22108 participants
  High

Phosphodiesterase 4 inhibitors vs placebo

• Phosphodiesterase‐4 inhibitors for chronic obstructive pulmonary disease 2020 · Cochrane Headline outcomes only
  no estimate extracted
  5 studies · 4245 participants
  Low

Phosphodiesterase 4 inhibitors vs placebo

• Phosphodiesterase‐4 inhibitors for chronic obstructive pulmonary disease 2020 · Cochrane Headline outcomes only
  no estimate extracted
  12 studies · 7645 participants
  Moderate

Phosphodiesterase 4 inhibitors vs placebo

Phosphodiesterase‐4 inhibitors leads to lower number of participants with 1 or more exacerbations compared with placebo (high certainty).

• Phosphodiesterase‐4 inhibitors for chronic obstructive pulmonary disease 2020 · Cochrane Headline outcomes only
  OR 0.78 [0.73, 0.84]
  27 studies · 20382 participants
  High

Phosphodiesterase 4 inhibitors vs placebo

Phosphodiesterase‐4 inhibitors may leads to higher number of participants experiencing an adverse event compared with placebo (low certainty).

• Phosphodiesterase‐4 inhibitors for chronic obstructive pulmonary disease 2020 · Cochrane Headline outcomes only
  OR 1.3 [1.22, 1.38]
  30 studies · 21310 participants
  Low

Phosphodiesterase 4 inhibitors vs placebo

Phosphodiesterase‐4 inhibitors leads to higher gastrointestinal adverse effects: diarrhoea compared with placebo (high certainty).

• Phosphodiesterase‐4 inhibitors for chronic obstructive pulmonary disease 2020 · Cochrane Headline outcomes only
  OR 3.1 [2.74, 3.5]
  29 studies · 20623 participants
  High

Phosphodiesterase 4 inhibitors vs placebo

Phosphodiesterase‐4 inhibitors probably leads to higher psychiatric adverse effects (roflumilast 500 µg) compared with placebo (moderate certainty).

• Phosphodiesterase‐4 inhibitors for chronic obstructive pulmonary disease 2020 · Cochrane Headline outcomes only
  OR 2.13 [1.79, 2.54]
  14 studies · 11168 participants
  Moderate