Table 6 Focused data extraction from additional studies identified by forward citation prior to publication
From: Systematic meta-review of supported self-management for asthma: a healthcare perspective
Reference; RCTs, n; Participants, n; Date range RCTs | Comparison | Relevance to meta-review questions: | Interventions included | Target group(s) | Synthesis | Main results |
|---|---|---|---|---|---|---|
What is the impact? Target groups? Which components? Context? | ||||||
Systematic reviews | ||||||
Coelho 2016 [61] 17 RCTs; 5879 participants RCTs 2005–2013 | School-based asthma education vs. usual care. FU: minimum 1 mo | Target: Schoolchildren | Educational interventions to individuals, groups or classes by healthcare professionals, teachers, educators and/or IT. | Schoolchildren with asthma and/or whole school. | Narrative analysis | 6/17 showed a reduction in unscheduled care; 5/17 showed a reduction of the asthma symptoms; 5/17 reduced school absenteeism; 7/17 improved QoL of the individuals; 8/17 showed that asthma education improved knowledge. |
McLean 2016 [62] 5 RCTs 595 participants RCTs 2011–2013 | Interactive digital interventions vs. usual care. FU: 10 weeks to 12 mo | Impact Components: Technology-based interventions | Interactive intervention (i.e. entering data, receiving tailored feedback, making choices) accessed through an app that provides self-management information. | Adults (≥16 y) with asthma. | Meta-analysis | Meta-analyses (3 studies) showed no significant difference in asthma control (SMD 0.21, 95% CI −0.05 to 0.42) or asthma QoL (SMD 0.05, 95% CI −0.22 to 0.32) but heterogeneity was very high. Removal of the outlier study reduced heterogeneity and indicated significant improvement for both asthma control (SMD 0.54, 95% CI 0.22–0.86) and asthma QoL (SMD 0.45, 95% CI 0.13–0.77). |
Randomised trials | ||||||
Hoskins 2016 [63] 48 participants | Goal-setting + SM/PAAPs vs. usual care. | Components: Goal-setting | Practice asthma nurses trained in goal-setting approach. | Primary care patients due a review. | Cluster feasibility RCT. FU: 6 mo | Difficulty recruiting: 10/124 practices participated and 48 patients. No between-group difference in QoL [mAQLQ I: 6.20 (SD 0.76, 95% CI 5.76–6.65) vs. C: 6.1 (SD 0.81, 95% CI 5.63–6.57), MD 0.1]. |
Morawska 2016 [64] 107 participants | Generic parenting skills vs usual care. | Components: Parenting skills | Parenting skills for managing LTCs + asthma ‘take-home tips sheets’. | Parents of children 2–10 y with asthma and/or eczema. | RCT. FU: 6 mo | Between-group improvement in parents’ self-efficacy and childs’ ‘eczema behaviour’, but not equivalent asthma outcomes. Parent and family generic QoL improved (p = 0.01). |
Plaza 2015 [65] 230 participants | Trained practices (I) vs. specialist unit (Is) vs. usual care (C). | Impact: Components: Education programme | Basic information on asthma, inhaler technique; provision of a PAAP. | Adults with persistent asthma. | Cluster RCT. FU: 12 mo | I groups had fewer unscheduled visits [I: 0.8 (SD 1.4) and Is: 0.3 (SD 0.7) vs. C:1.3 (SD 1.7); p = 0.001], and greater improvements in asthma control (p = 0.042) and QoL (p = 0.019). |
Rice 2015 [66] 711 participants | PAAP + inpatient lay educator vs. PAAP. | Components: Inpatient lay educator | Encourage FU attendance, build self-efficacy, set goals, overcome barriers. | Children 2–17 y admitted with asthma. | RCT. FU: 1 mo | No difference in attendance at FU appointment. I group had greater preventer use (OR 2.4, 95% CI 1.3–4.2), PAAP ownership (OR 2.0, 95% CI 1.3–3.0) and improved self-efficacy (p = 0.04). |
Yeh 2016 [67] 76 participants | Family programme (+PAAP) vs. usual care (+PAAP). | Components: Family empowerment | Family empowerment to reduce parental stress, increase family functioning. | Children 6–12 y with asthma. | RCT. FU: 3 mo | I families had reduced parental stress index (p = 0.026) and improved family environment scores (p < 0.0001), improved lung function, less disturbed sleep, less cough but no difference in wheeze. |
Zairina 2016 [68] 72 participants | Telehealth supported PAAP vs. usual care. | Components: Telehealth | Telehealth (FEV1, symptoms) monitored weekly. | Pregnant women with moderate/severe asthma | RCT. FU: 6 mo | Telehealth improved ACQ [MD 0.36 (SD 0.15, 95% CI −0.66 to −0.07)] and mAQLQ [MD 0.72 (SD 0.22; 95% CI 0.29–1.16)]. No difference in perinatal outcomes. |