WeChat as a Platform for Baduanjin Intervention in Patients With Stable Chronic Obstructive Pulmonary Disease in China: Retrospective Randomized Controlled Trial

Effects of Wab-WPPEP on post-intensive care syndrome-family in family caregivers of heart valve replacement patients: A randomized controlled trial

OBJECTIVES

To evaluate the effects of a WeChat applet-based whole process psychological empowerment program (Wab-WPPEP) on post-intensive care syndrome-family in family caregivers of heart valve replacement patients.

DESIGN

Two-arm, parallel, randomized controlled clinical trial.

SETTINGS

A tertiary general hospital in Fuzhou, China.

METHODS

Participants were randomly assigned to two groups. The intervention group received Wab-WPPEP, while the control group received routine care. The intervention was implemented from ICU admission to one month post-discharge. The primary outcome was anxiety, while secondary outcomes included depression, post-traumatic stress disorder (PTSD), and quality of life. Outcomes were assessed at baseline (T0), before ICU transfer (T1), pre-discharge (T2), and one month post-discharge (T3) using standardized questionnaires. Generalized estimating equations were used to analyze the repeated-measures data.

RESULTS

The intervention group exhibited greater improvements in anxiety (T1: β = -1.92, 95 % CI: -2.35 to -1.49, P < 0.001; T2: β = -1.66, 95 % CI: -2.03 to -1.29, P < 0.001; T3: β = -3.98, 95 % CI: -4.34 to -3.62, P < 0.001), depression (T1: β = -1.32, 95 % CI: -1.79 to -0.85, P < 0.001; T2: β = -1.70, 95 % CI: -2.08 to -1.32, P < 0.001), and quality of life (T2: β = 31.16, 95 % CI: 21.35 to 40.98, P < 0.001) compared to the routine-care group. PTSD scores were also significantly lower in the intervention group (t = -6.454, P < 0.001).

CONCLUSIONS

Wab-WPPEP significantly reduced anxiety and depression, improved quality of life, and alleviated PTSD symptoms in family caregivers of heart valve replacement patients.

IMPLICATIONS FOR CLINICAL PRACTICE

Comprehensive psychological interventions should be implemented throughout the ICU stay and recovery period to improve family caregiver well-being.

Effect of Baduanjin exercise on health and functional status in patients with chronic obstructive pulmonary disease: a community-based, cluster-randomized controlled trial

Baduanjin has been shown to be an effective method of exercise for promoting body function in patients with chronic obstructive pulmonary disease (COPD). However, this method is rarely used by rural doctors in rural communities. The aim of this study was to compare the therapeutic effects of Baduanjin exercise with those of conventional pulmonary rehabilitation (CPR) implemented by rural doctors in patients with COPD. A total of 472 COPD patients from 18 village clinics were randomly allocated to the Baduanjin group (n = 158), CPR group (n = 154), or control group (n = 160). The Baduanjin group received six months of Baduanjin training, the CPR group received six months of rehabilitation training, and the control group received usual care. The primary outcomes were changes in health status, as measured by the COPD Assessment Test (CAT), and dyspnoea, as assessed via the modified Medical Research Council (mMRC) dyspnoea scale. The secondary outcomes included six-minute walking distance (6MWD) performance and anxiety and depression scores on the Hospital Anxiety and Depression Scale (HADS-A and HADS-D, respectively). Baseline data were collected before randomization, and outcomes were ascertained at the six-month follow-up by blinded assessors. After six months of training, compared with the control group, the Baduanjin group presented significant improvements in CAT scores (t = 5.121, P < 0.001), mMRC scale scores (t = 5.719, P < 0.001), 6MWD performance (t = 12.608, P < 0.001), HADS-A scores (t = 6.210, P < 0.001), and HADS-D scores (t = 2.945, P = 0.010). The CPR group also presented significant improvements in CAT scores (t = 4.725, P < 0.001), mMRC scale scores (t = 5.499, P < 0.001), 6MWD performance (t = 11.662, P < 0.001), HADS-A scores (t = 5.697, P < 0.001), and HADS-D scores (t = 2.671, P = 0.023). In contrast, the control group participants showed no significant changes in CAT scores (t = -0.252, P = 0.801), mMRC scale scores (t = -0.085, P = 0.932), 6MWD performance (t = -0.463, P = 0.644), HADS-A scores (t = -2.75, P = 0.783), or HADS-D scores (t = -0.281, P = 0.779). No adverse events were reported during the study. The positive effects of Baduanjin exercise on the subjective symptoms of COPD patients are similar to those of CPR. The trial was registered with the Chinese Clinical Trials Registry (reference: ChiCTR-TRC-12001958) (22/02/2012).

Long-term follow-up of the treatment for severe COVID-19 with qigong exercise and acupressure: A randomized controlled trial

Background

Most clinical trials have reported significant short-term effects of traditional medicine therapies on COVID-19 patients. However, there is no clinical trial to determine the long-term effects of traditional medicine therapies on severe COVID-19 patients.

Methods

A total of 128 patients with severe COVID-19, who were recruited in our previous clinical trial following hospital discharge, were monitored at months 14 and 28. This trial aims to evaluate the long-term effect of an early Qigong exercise and acupressure rehabilitation program on patients with severe COVID-19.The intervention group received qigong exercise and acupressure therapy, plus standard therapies. The control group received standard therapies.The study was a single-center, parallel, randomized, prospective follow-up study. The outcomes of the study included changes in the modified Borg dyspnea scale (MBS), the modified Medical Research Council dyspnea scale (mMRC), the patient health questionnaire-9 scale (PHQ-9), the activity of daily living (ADL), the remaining clinical symptoms and any intervention related adverse events.

Results

The intervention group showed a statistically significant improvement in the mMRC scores (-0.4, 95 % CI (-0.6, 0.2), P < 0.001) and the MBS scores (-0.6, 95 % CI (-0.9, -0.3), P < 0.001) after 14 months of discharge compared with the control group. At 28 months of discharge, the intervention group, compared with the control group alone, significantly increased their MBS scores (-0.4, 95 % CI (-0.7, -0.1), P = 0.024) and a significantly decreased positive rate of dyspnea symptoms after 14 months of discharge (P < 0.05). However, ADL and PHQ-9 scores showed no significant difference between the two groups during the follow-up (P > 0.05).

Conclusions

QARP had long-term sustained efficacy for dyspnea, chest tightness, and cough in patients with COVID-19, especially in young and middle-aged patients, and the effect was significant at the 14th month of follow-up.

Trial registration

This trial was registered at the China Clinical Trial Registry (ChiCTR2100044572).

A literature review of Chinese traditional Baduanjin qigong for perimenopausal and postmenopausal symptoms

This review aimed to evaluate the effectiveness and safety of Baduanjin qigong on perimenopausal and postmenopausal symptoms based on clinical trials. A literature search was conducted in 7 databases up to June 30, 2023. The information of study design and observed indicator based on perimenopausal and postmenopausal stage was extracted. We mainly analyzed the effectiveness, safety and the methodology quality. Thirty-five trials were selected, and 17 original studies were considered good methodological quality. During perimenopause, Baduanjin was mainly to treat mood disorders (63.64%, 14/22), among which 6 (42.86%, 6/14) were depression, 2 (14.29%, 2/14) were depression and anxiety, and 1 (7.14%, 1/14) was anxiety, as well as 5 (35.71%, 5/14) sleep disorders. And the exercise program had a duration of 45 to 50 minutes (57.14%, 8/14), 7 times (71.43%, 10/14) a week. The programs lasting 3 months (42.86%, 6/14), accounted for the highest proportion of the exercise program. In the postmenopausal stage, Baduanjin was used to treat osteoporosis (84.62%, 11/13). From the data available, the program with 2 to 3 times a day (81.82%, 9/11) reported the highest number of significant effects, with a maximum duration of 12 months (55.56%, 5/9), followed by 6 months (33.33%, 3/9). A total of 8 trials mentioned the adverse reactions, but none was related to Baduanjin, and the dropout of participants (1.96%, 57/2912) was also not associated with Baduanjin. There is evidence for positive effects of Baduanjin in addressing perimenopausal mental disorders and postmenopausal osteoporosis, but more research is necessary to clarify best practices and quantify results.

Effects of different traditional Chinese exercises on pulmonary function in patients with stable chronic obstructive pulmonary disease: a network meta-analysis

OBJECTIVE

Traditional Chinese exercises (Taichi, Wuqinxi, Liuzijue, and Baduanjin) are considered effective alternative treatments for improving symptoms in the stable phase of COPD. However, the most effective exercise remains unknown. This study compared the effectiveness of different traditional Chinese exercises on pulmonary function in patients with stable chronic obstructive pulmonary disease (COPD) using a network meta-analysis.

METHODS

From database establishment until September 2023, eligible randomized controlled trials (RCTs) were searched. Two reviewers performed the risk of bias assessment of the included studies using the Cochrane Collaboration tool, and the evidence level was suggested using the GRADE system.

RESULTS

Fifty-seven studies comprising 4294 patients were included. The results of the network meta-analysis show that Baduanjin was most effective in improving the forced expiratory volume in the first second (FEV1). However, Liuzijue significantly improved the first-second forced vital capacity percentage of expected value (FEV1%) and the ratio of the forced expiratory volume in the first second to the forced vital capacity (FEV1/FVC). The probability ranking results indicated that Liuzijue was the most effective, followed by Baduanjin, Wuqinxi, and Taichi. Subgroup analysis in conjunction with intervention duration revealed that Liuzijue had a significant advantage over other interventions for improving FEV1, FEV1%, and FEV1/FVC within 6 months and improved FEV1% and FEV1/FVC for ≥ 6 months. Moreover, Subgroup analysis based on baseline pulmonary function revealed that Liuzijue had a significant advantage over other interventions for improving FEV1% within severe and moderate groups. Finally, Subgroup analysis based on the frequency of interventions showed that Liuzijue was still more effective in improving FEV1, FEV1%, and FEV1/FVC in the ≥ three times one week.

CONCLUSION

Liuzijue was more effective than Taichi, Wuqinxi, Liuzijue, and Baduanjin in improving pulmonary function in patients with stable COPD.

Digital Medical Information Services Delivered by Pharmaceutical Companies via WeChat: Qualitative Analytical Study

BACKGROUND

Social media has become one of the primary information sources for medical professionals and patients. Pharmaceutical companies are committed to using various social media platforms to provide stakeholders with digital medical information services (DMISs), which remain experimental and immature. In China, WeChat tops the list of popular social media platforms. To date, little is known about the service model of DMISs delivered by pharmaceutical companies via WeChat.

OBJECTIVE

This study aims to explore the emerging service model of DMISs delivered by pharmaceutical companies via WeChat in China.

METHODS

This study applied a qualitative research design combining case study and documentary analysis to explore the DMISs of 6 leading pharmaceutical companies in China. Materials were collected from their official WeChat platforms. Thematic analysis was conducted on the data.

RESULTS

The DMISs of 6 pharmaceutical companies were investigated. Themes emerged regarding 2 essential information services delivered by pharmaceutical companies via WeChat: business operation services and DMISs (ie, public information services, professional services, science and education services, and e-commerce services). Business operation services mainly function to assist or facilitate the company's operations and development trends for general visitors. Public-oriented information services are realized through health science popularization, academic frontiers, product information, and road maps to hospitals and pharmacies. Internet hospital and pharmacy services are the main patient-oriented professional services. Medical staff-oriented science and education services commonly include continuing education, clinical assistance, academic research, and journal searching. Public-oriented e-commerce services include health products and health insurance.

CONCLUSIONS

Pharmaceutical companies in China use WeChat to provide stakeholders with diversified DMISs, which remain in the exploratory stage. The service model of DMISs requires more distinct innovations to provide personalized digital health and patient-centric services. Moreover, specific regulations on the DMISs of pharmaceutical companies need to be established to guard public health interests.

Evaluation of Social Platform-Based Continuity of Care in Improving Cognitive and Prognostic Effects of Young Patients with Diabetic Retinopathy

Objective

This study was performed to evaluate the effectiveness of social platform-based continuity of care in improving cognitive and prognostic effects of young age diabetic patients without diabetic retinopathy (DR).

Methods

A total of 88 young age diabetic patients admitted to the outpatient clinic of First Affiliated Hospital of Soochow University (Endocrine and Ophthalmology Outpatient) from January 2021 to May 2022 were recruited and assigned via random number table method to receive either routine follow-up care (routine group) or social platform-based continuity of care (WeChat group), with 44 patients in each group. Treatment compliance, cognitive-behavioral ability, self-care ability (self-care responsibility, self-care skills, self-status, knowledge of diabetic retinopathy), quality of life (physical function, psychosocial, symptom and visual function, social activity), and prognosis of the patients were analyzed to investigate the effectiveness of WeChat social platform-based continuity of care. All patients were followed up for one year.

Results

Patients receiving WeChat social platform-based continuity of care exhibited obviously higher treatment compliance and better cognitive-behavioral ability, self-care responsibility, self-care skills, self-state, and diabetic retinopathy knowledge follow-up than those with routine care (P<0.05). Patients in the WeChat group had significantly better physical function, mental psychology, symptoms and visual function, and social activity levels than those in the routine group (P<0.05). WeChat-based continuity of care resulted in a significantly lower incidence of visual acuity loss and diabetic retinopathy during follow-up than routine care (P<0.05).

Conclusion

WeChat social platform-based continuity of care effectively improves treatment compliance and diabetic retinopathy awareness, and enhances self-care ability of young patients with diabetes mellitus. The life quality of these patients is improved and the risk of poor prognosis has been reduced.

Characteristics, Components, and Efficacy of Telerehabilitation Approaches for People with Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-Analysis

INTRODUCTION

Chronic obstructive pulmonary disease (COPD) is at the top of the list of non-communicable diseases with related rehabilitation needs. Digital medicine may provide continuative integrated intervention, overcoming accessibility and cost barriers.

METHODS

We systematically searched for randomized controlled trials on telerehabilitation (TR) in people with COPD to profile the adopted TR strategies, focusing on TR models and the main rehabilitation actions: monitoring and assessment, decision, and feedback. Additionally, a meta-analysis was run to test the TR effect on functional capacity, dyspnea, and quality of life compared to no intervention (NI) and conventional intervention (CI).

RESULTS

Out of the 6041 studies identified, 22 were eligible for the systematic review, and 14 were included in the meta-analyses. Results showed a heterogeneous scenario in terms of the TR features. Furthermore, only a small group of trials presented a comprehensive technological kit. The meta-analysis highlighted a significant effect of TR, especially with the asynchronous model, on all outcomes compared to NI. Moreover, a non-inferiority effect of TR on functional capacity and quality of life, and a superiority effect on dyspnea compared to CI were observed. Finally, the studies suggested a high rate of TR adherence and high safety level.

CONCLUSIONS

TR is an effective strategy to increase and maintain functional capacity, breath, and quality of life in people with COPD. However, a consensus on the essential elements and features of this approach needs to be defined, and the effect of long-term maintenance merits further investigation.

Community lung health service design for COPD patients in China by the Breathe Well group

COPD is increasingly common in China but is poorly understood by patients, medications are not used as prescribed and there is no access to recommended non-pharmacological treatment. We explored COPD patients’ and general practitioners’ (GPs) knowledge of COPD, views on its management and the acceptability of a flexible lung health service (LHS) offering health education, exercise, self-management, smoking cessation and mental health support. Using a convergent mixed methods design, data were collected from patients and GPs using focus groups (FGs) in four Chinese cities, questionnaires were also used to collect data from patients. FGs were audio-recorded and transcribed. Quantitative data were analysed descriptively, thematic framework analysis was used for the qualitative data. Two-hundred fifty-one patients completed the questionnaire; 39 patients and 30 GPs participated in ten separate FGs. Three overarching themes were identified: patients’ lack of knowledge/understanding of COPD, current management of COPD not meeting patients’ needs and LHS design, which was well received by patients and GPs. Participants wanted COPD education, TaiChi, psychological support and WeChat for social support. 39% of survey responders did not know what to do when their breathing worsened and 24% did not know how to use their inhalers. 36% of survey respondents requested guided relaxation. Overall, participants did not fully understand the implications of COPD and current treatment was sub-optimal. There was support for developing a culturally appropriate intervention meeting Chinese patients’ needs, health beliefs, and local healthcare delivery. Further research should explore the feasibility of such a service.

The Long-Term Maintenance Effect of Remote Pulmonary Rehabilitation via Social Media in COPD: A Randomized Controlled Trial

Background

Although the benefits of conventional pulmonary rehabilitation (PR) maintenance are well documented, it is challenged by many difficulties. We investigated whether remote home-based PR maintenance strategy via social media (WeChat) is effective on clinical improvements and reducing the risk for acute exacerbation of chronic obstructive pulmonary disease (COPD).

Methods

The eligible stable COPD patients completing an initial 8-week PR were allocated into three groups randomly. Group A: PR maintenance via social media supervision at home. Group B: PR maintenance at hospital. Group C: Usual care. During a 12-month follow-up, the frequency of acute exacerbation of COPD (AECOPD), 6 minutes walking test (6MWT), COPD assessment test (CAT), and modified Medical Research Council scale (mMRC) were evaluated every 3 months.

Results

At the end of the follow-up, compared to the decline in the usual care group (n = 49), the clinical improvements of 6MWD, CAT, and mMRC were sustained in both the home-based group (n = 47) and the hospital-based maintenance group (n = 44) (p < 0.001), no difference was observed between these two groups (p > 0.05). In multivariate analysis, the home-based PR maintenance and hospital-based PR maintenance were independent predictors of lower risk for AECOPD (incidence rate ratio (IRR) 0.712, 95% CI 0.595–0.841, p < 0.001 and IRR 0.799, 95% CI 0.683–0.927, p = 0.002), respectively.

Conclusion

Remote PR maintenance via social media is effective in reducing the risk for AECOPD and keeping the clinical improvement from decline. Remote PR maintenance via social media might be used to deliver alternatives to conventional PR.

[Features of adherence to treatment of patients with chronic rhinosinusitis with nasal polyps]

Chronic polypous rhinosinusitis (CPR) is characterized by refractory to drug therapy and a high potential for recurrence after surgical treatment. One of the important factors limiting the effectiveness of drug therapy of CPR, in particular intranasal glucocorticosteroids (inGCSs), is the insufficient level of adherence to treatment of patients with CPR.

OBJECTIVE

Generalization of data on the significance and ways to increase adherence to treatment of patients with CPR.

MATERIAL AND METHODS

Materials of scientific publications included in the Cochrane Library, Russian Science Citation Index, MEDLINE, PubMed information bases were used as a data source. The material was selected based on the following keywords: "chronic rhinosinusitis", "nasal polyps", "intranasal glucocorticosteroids", "adherence to treatment".

RESULTS

Despite the fact that inGCSs are one of the main pathogenetically justified methods of treating CPR, their use is limited by many factors, one of which is the level of patient compliance with the treatment regimen.

CONCLUSION

Improving adherence to treatment is one of the important reserves for increasing the effectiveness of drug therapy for chronic polypous rhinosinusitis.

The effect of mind-body exercise on cervical spine mobility of people with neck discomfort: A systemic review and meta-analysis of randomised controlled trials

BACKGROUND

Long-term and high-intensity work can lead to considerable discomfort in people's cervical spines.

OBJECTIVES

This study sought to explore the effect of mind-body exercise intervention on the cervical spine mobility of people with neck discomfort through meta-analysis.

METHODS

This study's researchers were searched a total of five research databases for data retrieval: China National Knowledge Infrastructure (from 1979), Web of Science (from 1950), PubMed (from 1965), Cochrane (from 1991), and EBSCO (from 1949) (Date of retrieval: March 10, 2021). Two authors independently searched literature records, scanned titles, abstracts, and full texts, collected data, and assessed materials for risk of bias. Stata14.0 software was used for the data analysis (Registration number: INPLASY202140126).

RESULTS

Four articles were finally included with a total of 208 participants, and their age range was 18-65 years old. (1) Mind-body exercise intervention had a significant improving effect on Cervical extension, effect size of [SMD = 0.51 (95% CI 0.13 to 0.88), p <0.01; I2 = 45.2%], there was moderate heterogeneity; Mind-body exercise intervention had a significant improving effect on Cervical flexion, effect size of [SMD = 0.61 (95% CI 0.32 to 0.90), p <0.01; I2 = 5.7%], no heterogeneity; (2) Mind-body exercise intervention was no effect on the other four cervical range of motions; (3) The difference in participant's neck discomfort was the source of heterogeneity, and all results had the potential risk of publication bias.

CONCLUSION

This study showed that mind-body exercise had a positive effect on the extension and flexion of people with neck discomfort. However, further research and more reliable evidence were needed to prove that mind-body exercise could be used for the treatment of neck discomfort.

Self-management interventions for people with chronic obstructive pulmonary disease

BACKGROUND

Self-management interventions help people with chronic obstructive pulmonary disease (COPD) to acquire and practise the skills they need to carry out disease-specific medical regimens, guide changes in health behaviour and provide emotional support to enable them to control their disease. Since the 2014 update of this review, several studies have been published.

OBJECTIVES

Primary objectives To evaluate the effectiveness of COPD self-management interventions compared to usual care in terms of health-related quality of life (HRQoL) and respiratory-related hospital admissions. To evaluate the safety of COPD self-management interventions compared to usual care in terms of respiratory-related mortality and all-cause mortality. Secondary objectives To evaluate the effectiveness of COPD self-management interventions compared to usual care in terms of other health outcomes and healthcare utilisation. To evaluate effective characteristics of COPD self-management interventions.

SEARCH METHODS

We searched the Cochrane Airways Trials Register, CENTRAL, MEDLINE, EMBASE, trials registries and the reference lists of included studies up until January 2020.

SELECTION CRITERIA

Randomised controlled trials (RCTs) and cluster-randomised trials (CRTs) published since 1995. To be eligible for inclusion, self-management interventions had to include at least two intervention components and include an iterative process between participant and healthcare provider(s) in which goals were formulated and feedback was given on self-management actions by the participant.

DATA COLLECTION AND ANALYSIS

Two review authors independently selected studies for inclusion, assessed trial quality and extracted data. We resolved disagreements by reaching consensus or by involving a third review author. We contacted study authors to obtain additional information and missing outcome data where possible. Primary outcomes were health-related quality of life (HRQoL), number of respiratory-related hospital admissions, respiratory-related mortality, and all-cause mortality. When appropriate, we pooled study results using random-effects modelling meta-analyses.

MAIN RESULTS

We included 27 studies involving 6008 participants with COPD. The follow-up time ranged from two-and-a-half to 24 months and the content of the interventions was diverse. Participants' mean age ranged from 57 to 74 years, and the proportion of male participants ranged from 33% to 98%. The post-bronchodilator forced expiratory volume in one second (FEV1) to forced vital capacity (FVC) ratio of participants ranged from 33.6% to 57.0%. The FEV1/FVC ratio is a measure used to diagnose COPD and to determine the severity of the disease. Studies were conducted on four different continents (Europe (n = 15), North America (n = 8), Asia (n = 1), and Oceania (n = 4); with one study conducted in both Europe and Oceania). Self-management interventions likely improve HRQoL, as measured by the St. George's Respiratory Questionnaire (SGRQ) total score (lower score represents better HRQoL) with a mean difference (MD) from usual care of -2.86 points (95% confidence interval (CI) -4.87 to -0.85; 14 studies, 2778 participants; low-quality evidence). The pooled MD of -2.86 did not reach the SGRQ minimal clinically important difference (MCID) of four points. Self-management intervention participants were also at a slightly lower risk for at least one respiratory-related hospital admission (odds ratio (OR) 0.75, 95% CI 0.57 to 0.98; 15 studies, 3263 participants; very low-quality evidence). The number needed to treat to prevent one respiratory-related hospital admission over a mean of 9.75 months' follow-up was 15 (95% CI 8 to 399) for participants with high baseline risk and 26 (95% CI 15 to 677) for participants with low baseline risk. No differences were observed in respiratory-related mortality (risk difference (RD) 0.01, 95% CI -0.02 to 0.04; 8 studies, 1572 participants ; low-quality evidence) and all-cause mortality (RD -0.01, 95% CI -0.03 to 0.01; 24 studies, 5719 participants; low-quality evidence). We graded the evidence to be of 'moderate' to 'very low' quality according to GRADE. All studies had a substantial risk of bias, because of lack of blinding of participants and personnel to the interventions, which is inherently impossible in a self-management intervention. In addition, risk of bias was noticeably increased because of insufficient information regarding a) non-protocol interventions, and b) analyses to estimate the effect of adhering to interventions. Consequently, the highest GRADE evidence score that could be obtained by studies was 'moderate'.

AUTHORS' CONCLUSIONS

Self-management interventions for people with COPD are associated with improvements in HRQoL, as measured with the SGRQ, and a lower probability of respiratory-related hospital admissions. No excess respiratory-related and all-cause mortality risks were observed, which strengthens the view that COPD self-management interventions are unlikely to cause harm. By using stricter inclusion criteria, we decreased heterogeneity in studies, but also reduced the number of included studies and therefore our capacity to conduct subgroup analyses. Data were therefore still insufficient to reach clear conclusions about effective (intervention) characteristics of COPD self-management interventions. As tailoring of COPD self-management interventions to individuals is desirable, heterogeneity is and will likely remain present in self-management interventions. For future studies, we would urge using only COPD self-management interventions that include iterative interactions between participants and healthcare professionals who are competent using behavioural change techniques (BCTs) to elicit participants' motivation, confidence and competence to positively adapt their health behaviour(s) and develop skills to better manage their disease. In addition, to inform further subgroup and meta-regression analyses and to provide stronger conclusions regarding effective COPD self-management interventions, there is a need for more homogeneity in outcome measures. More attention should be paid to behavioural outcome measures and to providing more detailed, uniform and transparently reported data on self-management intervention components and BCTs. Assessment of outcomes over the long term is also recommended to capture changes in people's behaviour. Finally, information regarding non-protocol interventions as well as analyses to estimate the effect of adhering to interventions should be included to increase the quality of evidence.

Support Life Club: A New Model Based on Social Media Group Chats and Social Activities That Can Improve Adherence and Clinical Outcomes in Patients Receiving Cardiac Rehabilitation

AIM

To describe a new model, the Support Life Club (SLC), for participants of Phase II cardiac rehabilitation (CR) programs and to evaluate this model for adherence, completion rates, and clinical outcomes.

METHODS

This retrospective study involved 391 consecutive patients who participated in an outpatient CR program between September 2016 and May 2020. The intervention group (SLC) was comprised of 198 patients who participated in education, WeChat-based group activity as well as outdoor activities, while the control group (non-intervention) was comprised of 193 cases. All patients attended a 12-week supervised outpatient CR program (three sessions per week, each lasting 40min). The intervention and control groups were compared for completion rates, Cardiopulmonary Exercise Test (CPET) results, Six-minute Walk Test (6MWT) distances, and Patient Health Questionnaire-9 (PHQ-9) scores.

RESULTS

Patients in the intervention group attended at least 75% of the exercise training sessions more often than those in the control group (72.5% vs 40.41%, adjusted odds ratio (OR): 27.385; 95% CI: 10.2 to 73.6; P = 0.0000). Analysis of variance (2 × 2 ANOVA) revealed a significant group-by-time interaction in PHQ9 and 6MWT test results (p = 0.000).

CONCLUSION

The addition of SLC to a cardiac rehabilitation program resulted in better outcomes for PHQ9 and 6MWT tests and may be a useful strategy to improve exercise adherence.

Instant messaging client gives the opportunity to recognize gut microbiota and dysbiosis-related disease: An investigation study on WeChat APP

Objectives

Gut microbiota and dysbiosis are closely related to the occurrence and development of various diseases. It is necessary to popularize gut microbiota-related knowledge to the public. And the instant messaging client on smartphones supplies a perfect tool to achieve this goal. Hence, we will describe the current status of gut microbiota education spread by WeChat official accounts.

Methods

The keywords of “gut microbiota,” “fecal microbiota transplantation (FMT),” and “probiotics” were searched in the articles published from January 2015 to August 2020 on the WeChat official accounts. And the data were analyzed based on the 10 common gut dysbiosis-related diseases.

Results

A total of 3061 WeChat official accounts have published 11,239 articles on gut microbiota dysbiosis-related diseases, with a rising trend in the total article numbers and the total pageviews. The keywords of “gut microbiota” dominate 50.61%, and the articles on inflammatory bowel disease had the largest proportion. Additionally, articles on the keyword “gut microbiota” also included cancer and obesity, articles on the keyword “FMT” mainly consist of Clostridium difficile infection and psychological disease, and the keyword “probiotics” was mainly related to obesity and irritable bowel syndrome disease. The top three total pageviews were on inflammatory bowel disease, obesity, and cancer.

Conclusion

This study indicates the current research hotspots and public concerns on the gut microbiota, and WeChat as an instant messaging client plays an important role in promoting the scientific popularization of gut microbiota.

Effects of pulmonary rehabilitation training based on WeChat App on pulmonary function, adverse mood and quality of life of COVID-19 patients: A protocol for systematic review and meta-analysis

BACKGROUND

Coronavirus disease 2019 (COVID-19) as a fatal epidemic has swept across the world, especially in India where the epidemic situation is the most serious. For COVID-19 patients, pulmonary rehabilitation training plays a significant role. However, it is still a controversial issue regarding the efficacy of WeChat APP-based pulmonary rehabilitation training in improving lung function, quality of life and bad mood of COVID-19 patients. To clarify this issue, a meta-analysis was conducted in this present study, so as to provide a basis for rehabilitation guidance of COVID-19 patients.

METHODS

We systematically searched PubMed, medRxiv, Web of Science, Scopus, Chinese Science Citation Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Chinese Scientific Journal Database, and Wan-fang databases in May 2021 to identify randomized controlled trials and evaluate the effects of WeChat APP-based pulmonary rehabilitation training for COVID-19. Two researchers independently carried out data extraction. On the other hand, literature quality evaluation on the quality and meta-analysis of the included literature was performed with Revman5.3 software.

RESULTS

The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.

CONCLUSION

This study will provide reliable evidence-based evidence on the effects of WeChat APP-based pulmonary rehabilitation training on lung function, bad mood, and quality of life in patients with COVID-19.

ETHICS AND DISSEMINATION

Ethical approval was not required for this study. The systematic review will be published in a peer-reviewed journal, presented at conferences, and shared on social media platforms.

OSF REGISTRATION NUMBER

DOI 10.17605/OSF.IO/MKXCH.