Mei Chan1, Melinda Gray2, Christine Burns2, Louisa Owens1,2, Susan Woolfenden1,2, Raghu Lingam1,2, Adam Jaffe1,2, Nusrat Homaira3,4. 1. Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2031, Australia. 2. Respiratory Department, Sydney Children's Hospital, Randwick, NSW 2031, Australia. 3. Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2031, Australia. n.homaira@unsw.edu.au. 4. Respiratory Department, Sydney Children's Hospital, Randwick, NSW 2031, Australia. n.homaira@unsw.edu.au.
Abstract
OBJECTIVE: We conducted a systematic review and meta-analysis to determine the effectiveness of comprehensive community-based interventions with ≥ 2 components in improving asthma outcomes in children. METHODS: A systematic search of Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (EMBASE), Cochrane Library and hand search of reference collections were conducted to identify any research articles published in English between 2000 and 2019. All studies reporting community-based asthma interventions with ≥ 2 components (e.g., asthma self-management education, home environmental assessment or care coordination etc.) for children aged ≤ 18 years were included. Meta-analyses were performed using random-effects model to estimate pooled odds ratio (OR) with 95% confidence intervals (CIs). RESULTS: Of the 2352 studies identified, 21 studies were included in the final analysis: 19 pre-post interventions, one randomised controlled trial (RCT) and one retrospective study. Comprehensive asthma programs with multicomponent interventions were associated with significant reduction in asthma-related Emergency Department (ED) visits (OR = 0.26; 95% CI 0.20-0.35), hospitalizations (OR = 0.24; 95% CI 0.15-0.38), number of days (mean difference = - 2.58; 95% CI - 3.00 to - 2.17) and nights with asthma symptoms (mean difference = - 2.14; 95% CI - 2.94 to - 1.34), use of short-acting asthma medications/bronchodilators (BD) (OR = 0.28; 95% CI 0.16-0.51), and increase use of asthma action plan (AAP) (OR = 8.87; 95% CI 3.85-20.45). CONCLUSION: Community-based asthma care using more comprehensive approaches may improve childhood asthma management and reduce asthma related health care utilization.
OBJECTIVE: We conducted a systematic review and meta-analysis to determine the effectiveness of comprehensive community-based interventions with ≥ 2 components in improving asthma outcomes in children. METHODS: A systematic search of Medline, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Excerpta Medica Database (EMBASE), Cochrane Library and hand search of reference collections were conducted to identify any research articles published in English between 2000 and 2019. All studies reporting community-based asthma interventions with ≥ 2 components (e.g., asthma self-management education, home environmental assessment or care coordination etc.) for children aged ≤ 18 years were included. Meta-analyses were performed using random-effects model to estimate pooled odds ratio (OR) with 95% confidence intervals (CIs). RESULTS: Of the 2352 studies identified, 21 studies were included in the final analysis: 19 pre-post interventions, one randomised controlled trial (RCT) and one retrospective study. Comprehensive asthma programs with multicomponent interventions were associated with significant reduction in asthma-related Emergency Department (ED) visits (OR = 0.26; 95% CI 0.20-0.35), hospitalizations (OR = 0.24; 95% CI 0.15-0.38), number of days (mean difference = - 2.58; 95% CI - 3.00 to - 2.17) and nights with asthma symptoms (mean difference = - 2.14; 95% CI - 2.94 to - 1.34), use of short-acting asthma medications/bronchodilators (BD) (OR = 0.28; 95% CI 0.16-0.51), and increase use of asthma action plan (AAP) (OR = 8.87; 95% CI 3.85-20.45). CONCLUSION: Community-based asthma care using more comprehensive approaches may improve childhood asthma management and reduce asthma related health care utilization.
Authors: Laura J Rolke; Sarah F Griffin; Joel Hamilton; Rachel Mayo; Joel E Williams; Lior Rennert; Kerry K Sease Journal: J Patient Exp Date: 2022-04-18
Authors: Nusrat Homaira; Emma Dickins; Stephanie Hodgson; Mei Chan; Sandra Wales; Melinda Gray; Sarah Donnelly; Christine Burns; Louisa Owens; Michael Plaister; Anthony Flynn; Jennifer Andresen; Kimberley Keane; Karen Wheeler; Bronwyn Gould; Nadine Shaw; Adam Jaffe; Christie Breen; Lisa Altman; Susan Woolfenden Journal: Front Pediatr Date: 2022-09-23 Impact factor: 3.569