Evidence map›Paper›PMID 20538819›Full record

Trial reportChest2010

Objective airway monitoring improves asthma control in the cold and flu season: a cluster randomized trial.

Susan L Janson, Kelly Wong McGrath, Jack K Covington, Robert B Baron, Stephen C Lazarus

Abstract readComparative StudyRandomized Controlled Trial
In one paragraph

Trial report in Chest, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Psychosocial factors and behavioral medicine interventions in asthma.Journal of consulting and clinical psychology · 2013
    Pooled it
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Susan L JansonSchool of Nursing, University of California, 2 Koret Way, San Francisco, CA 94143-0608, USA. Susan.Janson@nursing.ucsf.edu
Kelly Wong McGrath
Jack K Covington
Robert B Baron
Stephen C Lazarus

Funding

Cueing Patient-Clinican Collaboration to Improve AsthmaR01HL073098 · NHLBI · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI JANSON, SUSAN L · 2004 to 2007
$2.1M
NHLBI NIH HHS R01 HL073098NHLBI NIH HHS R01HL073098
6 · The paper itself

Abstract

backgroundThe goals of asthma care are reductions in risk and impairment, but achieving these goals requires collaborative work between patients and their clinicians. The purpose of this study was to improve inhaled corticosteroid (ICS) adherence and asthma control by cueing therapeutic communication between patients with asthma and their primary care clinicians.

methodsWe conducted a prospective, cluster-randomized, controlled effectiveness trial to assess the effect of providing visually standardized, interpreted peak flow graphs (CUE intervention) to patients and their clinicians on ICS adherence and asthma control. Asthma control outcomes were analyzed by season to account for seasonal variations in exacerbation frequency.

resultsAlthough mean log-transformed ICS adherence was not significantly different between the two groups, there was a trend toward preserved adherence in the intervention group over time (P = .16). Intervention patients required fewer courses of oral steroids during winter (9% vs 23%, P < .001) and spring (3% and 17%, P < .001) compared with control subjects. Intervention patients also had fewer periods of worsening symptoms (65% vs 89%, P < .001) and fewer urgent care visits (10% vs 23%, P < .001) during winter compared with control subjects. Post hoc analysis showed significant improvement in the intervention group with respect to ICS adherence during winter months (P < .05), the likely explanation for the reduction in prednisone use and symptoms. Day-to-day peak flow variability in the intervention group fell consistently throughout the study from an average of 32% at baseline to 23% at final measurement (P < .001), indicating less airway reactivity over time.

conclusionsOur findings provide evidence of the value of peak flow monitoring for patients with asthma during seasons of greatest vulnerability, the cold/flu season. The peak flow information apparently led to improvements in ICS adherence resulting in less need for prednisone rescue and fewer episodes of worsening symptoms.

Indexed as

Administration, InhalationAsthmaCluster AnalysisCommon ColdFemaleFollow-Up StudiesForced Expiratory VolumeGlucocorticoidsHumansInfluenza, HumanMaleMiddle AgedMonitoring, PhysiologicProspective StudiesSeasonsTreatment OutcomeGlucocorticoids

Identifiers

PMID20538819
PMCPMC2972622

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.