skip to content
Dovepress - Open Access to Scientific and Medical Research
View our mobile site

8850

Educational and behavioral interventions for asthma: who achieves which outcomes? A systematic review

Review

(2207) Views  (717) Full article downloads

Authors: Noreen M Clark, Christopher Griffiths, Stephanie R Keteyian, et al

Published Date December 2010 Volume 2010:3 Pages 187 - 197
DOI: http://dx.doi.org/10.2147/JAA.S14772

Noreen M Clark1, Christopher Griffiths2, Stephanie R Keteyian1, Martyn R Partridge3
1Center for Managing Chronic Disease, University of Michigan, Ann Arbor, MI, USA; 2Primary Care, Queen Mary's School of Medicine and Dentistry, Barts and the London Centre for General Practice and Primary Care, London, UK; 3Department of Respiratory Medicine, Imperial College London, London, UK

Objectives: Randomized clinical trial (RCT) data reviewed for outcomes and processes associated with asthma educational and behavioral interventions provided by different types of health professionals.
Methods: Cochrane Collaboration, MEDLINE, PUBMED, Google Scholar search from 1998 to 2009 identified 1650 articles regarding asthma educational and behavioral interventions resulting in 249 potential studies and following assessment produced a final sample of 50 RCTs.
Results: Approaches, intended outcomes, and program providers vary greatly. No rationale provided in study reports for the selection of specific outcomes, program providers, or program components. Health care utilization and symptom control have been the most common outcomes assessed. Specific providers favor particular teaching approaches. Multidisciplinary teams have been the most frequent providers of asthma interventions. Physician-led interventions were most successful for outcomes related to the use of health care. Multidisciplinary teams were best in achieving symptom reduction and quality of life. Lay persons were best in achieving self-management/self-efficacy outcomes. Components most frequently employed in successful programs are skills to improve patient–clinician communication and education to enhance patient self-management. Fifty percent of interventions achieved reduction in the use of health care and one-third in symptom control. A combination approach including self-management and patient–clinician communication involving multidisciplinary team members may have the greatest effect on most outcomes.
Conclusions: The extent to which and how different providers achieve asthma outcomes through educational and behavioral interventions is emerging from recent studies. Health care use and symptom control are evolving as the gold standard for intervention outcomes. Development of self-management and clinician–patient communication skills are program components associated with success across outcomes and providers.

Keywords: interventions, asthma, health professionals, systematic review




 

Other articles by Dr Noreen Clark



Readers of this article also read:

Introduction of Asthma APGAR tools improve asthma management in primary care practices
Asthma-related productivity losses in Alberta, Canada
The impact of food allergy on asthma
A systematic review of economic evaluations of therapy in asthma
Current recommendations for the treatment of mild asthma
New therapies and management strategies in the treatment of asthma: patient-focused developments
Effectiveness of inhaler types for real-world asthma management: retrospective observational study using the GPRD
Clinical update on the use of biomarkers of airway inflammation in the management of asthma
Successful treatment of reactive airways dysfunction syndrome by high-dose vitamin D
Thioperamide induces CD4+ CD25+ Foxp3+ regulatory T lymphocytes in the lung mucosa of allergic mice through its action on dendritic cells