We were interested in randomised controlled trials (RCTs), which investigated interventions designed to deliver or enhance holistic care (defined as addressing needs within at least three of physical, psychological, social or spiritual domains [7]) for patients with severe COPD in any healthcare context. The intervention could be part of a wider intervention (e.g. pulmonary rehabilitation or integrated care) if it satisfied the definition of a holistic intervention and measured an outcome of interest. Definitions of severe COPD were either a forced expiratory volume in one second (FEV1)