An Evidence Summary of Health Education in Chronic Obstructive Pulmonary Disease: A Practice-Oriented Assessment with Inter-Rater Reliability.

BACKGROUND

Chronic obstructive pulmonary disease (COPD) is the third leading cause of death worldwide, with a rising burden. Patients are mainly older adults with limited self-management abilities due to low education and cognitive decline. Systematic health education is key to improving disease knowledge and self-management; however, current programs lack standardized content, delivery, and implementation.

OBJECTIVE

To systematically search, appraise, and synthesize the best evidence on COPD health education, providing healthcare professionals with a rational basis for improving patients' disease knowledge and home-based self-management.

METHODS

This study was registered with the Open Science Framework. Following the "6S" evidence pyramid model and a top-down principle, we systematically searched the following databases and websites from inception to November 18, 2025: BMJ Best Practice, UpToDate, Cochrane Library, National Institute for Health and Care Excellence, Registered Nurses' Association of Ontario, Medlive, Guidelines International Network, American Thoracic Society, European Respiratory Society, Global Initiative for Chronic Obstructive Lung Disease, China National Knowledge Infrastructure, Wanfang Data, VIP Database, Sinomed, PubMed, Embase, and Web of Science. We included clinical practice guidelines, systematic reviews, and expert consensus. Quality was assessed using the AGREE II and JBI checklists. Evidence levels and recommendations were determined using the JBI Pre-grading System (2014).

RESULTS

Twenty-one publications were included (nine guidelines, eight systematic reviews, and four expert consensuses). Thirty-one evidence items were extracted and grouped into seven themes: educational principles, providers, recipients, methods, objectives, core content, and outcome assessment.

CONCLUSION

Effective COPD health education should shift from one-way knowledge transfer to patient-empowerment-based, interactive models. The content must be tailored to local resources, culture, and health literacy. A closed-loop "education-assessment-feedback" system, multidisciplinary teams, and smart technologies are recommended. Future research should focus on resource-limited settings, multidisciplinary implementation strategies and long-term digital intervention outcomes.