# The association between rural/urban residence status and patient-reported outcomes in individuals with Chronic Obstructive Pulmonary Disease (COPD): Protocol for a systematic review and meta-analysis

## TL;DR

This study will review how living in rural versus urban areas affects health outcomes reported by COPD patients.

## Contribution

This is the first systematic review to focus on patient-reported outcomes in COPD patients based on rural/urban residency.

## Key findings

- Rural residency is linked to higher COPD burden and worse health outcomes.
- Little is known about how rural/urban residence affects patient-reported outcomes in COPD.
- The study will use systematic review and meta-analysis to explore these associations.

## Abstract

Rural residency is associated with a disproportionate burden of chronic obstructive pulmonary disease (COPD) and poorer COPD health outcomes. While increasing focus has been placed on the influence of rural/urban residence on clinical outcomes, little is known about the impact of rural versus urban residency status on patient-reported outcome measures (PROMs) in individuals with COPD, despite the use of PROMs to tailor interventions and treatments to individual patient needs.

The objective of this review is to synthesize evidence of a relation between rural/urban residency status and PROMs in individuals with COPD.

Beginning May 2025, we will search EBSCO, Elsevier, Cochrane Library, PubMed, and relevant websites to identify research published between January 1, 2012, and November 1, 2024. Two reviewers will independently screen titles, abstracts, and full texts, with a third reviewer to resolve any discrepancies. All data sources and selection management will be fulfilled and housed in the Covidence systematic review software. The primary outcome of this review is the association between rural/urban residency and PROMs in individuals with COPD. If appropriate, a meta-analysis will be conducted. Sub-group analysis will be performed by sex. Sensitivity analysis will be performed by excluding studies with “low quality” based on risk of bias assessment.

This study is exempt from institutional review as it will be a secondary analysis of published data. Results of this study are expected by September 2025 and will be disseminated in a relevant peer-reviewed journal.

Prospero registration number: CRD42024627343.