Barriers and facilitators to treatment plan adoption and self-management in people with Chronic Obstructive Pulmonary Disease (COPD): A systematic search and narrative synthesis

Objective
To review the literature relating to patient barriers and facilitators to self-management in chronic obstructive pulmonary disease.
Methods
This review involved a systematic search and narrative synthesis. MEDLINE, CINAHL complete, PsycINFO and the Cochrane database of systematic reviews were systematically searched in March 2025. Search terms related to chronic obstructive pulmonary disease, self-management and potential barriers and facilitators to patient engagement or self-care. We reported according to PRISMA and analysis involved narrative synthesis.
Findings
Sixty-three papers were included. Barriers and facilitators to self-management were grouped across the following themes: i) healthcare systems (including time in appointments, treatment use and financial gateways), ii) emotions (incorporating stigma or emotional distress, positive outlook and acceptance of diagnosis or treatment), iii) communication with healthcare professionals (comprising understanding and perceived sufficiency of information, smoking habits, health behaviours and memory, tailoring needs and trust and person-centred care), iv) social factors (including support from family or friends and cultural or social norms) and v) environment (concerning environmental triggers and socioeconomic factors). Within these, challenges and enablers of self-management were encountered. Challenges included a lack of time in appointments, emotional distress and insufficient information from healthcare professionals. Enablers included positive outlook, support from family and friends and person-centred care.
Conclusions
This review has identified multiple patient barriers and facilitators to self-management in chronic obstructive pulmonary disease. Future interventions should be tailored to address the barriers whilst building upon the facilitators identified in this review.