Meta-analysis of the effects of psychoeducational care in adults with asthma.

Meta-analysis was conducted with 31 studies published between 1972 to 1993 on the effect of psychoeducational care (education, behavioral skill development, cognitive therapy, and/or nonbehavioral support/counseling) in adults with asthma. Fifty-eight percent of studies had subjects that were randomly assigned to treatment condition. Statistically significant beneficial effects were obtained on the occurance of asthmatic attacks (d+ = .56, n = 11), dynamic respiratory volume (d+ = .34, n = 10), peak expiratory flow rate (d+ = .29, n = 6), functional status (d+ = .46, n = 4), adherence to treatment regime (d+ = .78, n = 7), utilization of health care (d+ = .29, n = 10), use of PRN medications (d+ = .62, n = 8), psychological well-being (d+ = .53, n = 6), and psychomotor knowledge of inhaler use (d+ = 1.02, n = 4). Methodological weaknesses were identified that should be rectified in future research. Nonetheless, based on the best evidence available to date, both education and relaxation-based behavioral interventions have been shown to improve important clinical outcomes in adults with asthma.