Toward a standardized framework for chronic obstructive pulmonary disease self-care: An umbrella review.

BACKGROUND: Chronic obstructive pulmonary disease is the fourth leading cause of death worldwide, causing 3.5 million deaths in 2021, approximately 5% of global deaths. Its burden remains high because no disease-modifying therapy can halt progression. Current treatments mainly alleviate symptoms and reduce exacerbations. Self-care is therefore fundamental to long-term management, improving symptom control, exacerbations, and quality of life. However, chronic obstructive pulmonary disease self-care is defined and operationalized inconsistently across studies and programs, with widely varying components. Grounded in the tripartite structure of maintenance, monitoring, and management, a consolidated synthesis is needed to clarify core components, assess alignment with international guidance, and identify evidence gaps to support standardized practice and comparable research. OBJECTIVES: To (1) identify the core components of chronic obstructive pulmonary disease self-care; (2) map these components to international chronic obstructive pulmonary disease guidelines to determine areas of consensus and gaps; and (3) construct a standardized chronic obstructive pulmonary disease self-care framework for clinical practice and research. DESIGN: An umbrella review with a two-stage synthesis method, first extracting core components from international guidelines and then supplementing evidence gaps using systematic reviews. METHODS: We searched eight electronic databases (including PubMed, Web of Science, Scopus, Embase, and the Cochrane Library) from inception to April 20, 2026, for eligible reviews addressing chronic obstructive pulmonary disease self-care components. Two reviewers independently screened records, appraised methodological quality, and extracted data. Using a best-fit framework approach, guideline-derived self-care recommendations were organized within the maintenance, monitoring, and management structure and supplemented with evidence from systematic reviews to address gaps. RESULTS: From 8660 records identified, 14 reviews met the inclusion criteria. Ten core components of chronic obstructive pulmonary disease self-care were synthesized: (i) lifestyle modification; (ii) psychological coping and social support engagement; (iii) preventive vaccination uptake; (iv) adherence to medication and inhaler technique; (v) management of acute exacerbations; (vi) active participation in scheduled follow-up; (vii) acquisition and application of health literacy; (viii) daily monitoring and tracking of symptoms; (ix) proactive consultation for unplanned healthcare issues; and (x) self-directed access to health information and resources. Most components, particularly (i) to (vii), were broadly consistent with international chronic obstructive pulmonary disease guideline recommendations, indicating consensus on key self-care maintenance and management. In contrast, monitoring and patient-initiated engagement components, including (viii) to (x), were emerging components that are less explicitly represented in guidelines, highlighting gaps between formal recommendations and emerging practice. CONCLUSION: This umbrella review established a comprehensive, evidence-based framework comprising ten core self-care components for chronic obstructive pulmonary disease, bridging the gap between guideline recommendations and real-world practice. REGISTRATION: PROSPERO CRD42023464435, registered 14/5/2025.