Evidence map›Paper›PMID 27215329›Full record

SynthesisBMC pulmonary medicine2016

Interactive digital interventions to promote self-management in adults with asthma: systematic review and meta-analysis.

Gary McLean, Elizabeth Murray, Rebecca Band, Keith R Moffat, Peter Hanlon, Anne Bruton, Mike Thomas, Lucy Yardley, Frances S Mair

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC pulmonary medicine, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 31 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
31citing papers in PubMed, 11 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

31 citing papers in PubMed, 11 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Pooled it
  10. Pooled it
  11. Pooled it
  12. Trial
  13. Trial
  14. Trial
  15. Article
  16. Article
  17. Review
  18. Review
  19. Review
  20. 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

9 authors.

Gary McLeanInstitute of Health and Wellbeing, University of Glasgow, Glasgow, G12 9LX, UK. Gary.McLean@Glasgow.ac.uk.
Elizabeth MurrayResearch Department of Primary Care and Population Health, University College London, Rowland Hill Street, London, UK.
Rebecca BandAcademic Unit of Psychology, Faculty of Social and Human Sciences, University of Southampton, Southampton, UK.
Keith R MoffatInstitute of Health and Wellbeing, University of Glasgow, Glasgow, G12 9LX, UK.
Peter HanlonInstitute of Health and Wellbeing, University of Glasgow, Glasgow, G12 9LX, UK.
Anne BrutonFaculty of Health Sciences, University of Southampton, Southampton, UK.
Mike ThomasPrimary Care & Population Sciences, Aldermoor Health Centre, Aldermoor Close, Southampton, UK.
Lucy YardleyAcademic Unit of Psychology, Faculty of Social and Human Sciences, University of Southampton, Southampton, UK.
Frances S MairInstitute of Health and Wellbeing, University of Glasgow, Glasgow, G12 9LX, UK.

Funding

Department of Health RP-PG-1211-20001Department of Health SRF-2012-05-120
6 · The paper itself

Abstract

backgroundTo identify, summarise and synthesise the evidence for using interactive digital interventions to support patient self-management of asthma, and determine their impact.

methodsSystematic review with meta-analysis. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Cochrane Library, DoPHER, TROPHI, Social Science Citation Index and Science Citation Index. The selection criteria requirement was studies of adults (16 years and over) with asthma, interventions that were interactive digital interventions and the comparator was usual care. Outcomes were change in clinical outcomes, cost effectiveness and patient-reported measures of wellbeing or quality of life. Only Randomised Controlled Trials published in peer-reviewed journals in English were eligible. Potential studies were screened and study characteristics and outcomes were extracted from eligible papers independently by two researchers. Where data allowed, meta-analysis was performed using a random effects model.

resultsEight papers describing 5 trials with 593 participants were included, but only three studies were eligible for inclusion for meta-analysis. Of these, two aimed to improve asthma control and the third aimed to reduce the total dose of oral prednisolone without worsening control. Analyses with data from all three studies showed no significant differences and extremely high heterogeneity for both Asthma Quality of Life (AQLQ) (Standardised Mean Difference (SMD) 0.05; 95 % Confidence Interval (CI) 0.32 to -0.22: I2 96.8) and asthma control (SMD 0.21; 95 % CI -0.05 to .42; I2 = 87.4). The removal of the third study reduced heterogeneity and indicated significant improvement for both AQLQ (SMD 0.45; 95 % CI 0.13 to 0.77: I2 = 0.34) and asthma control (SMD 0.54; 95 % CI 0.22 to 0.86: I2 = 0.11). No evidence of harm was identified.

conclusionDigital self-management interventions for adults with asthma show promise, with some evidence of small beneficial effects on asthma control. Overall, the evidence base remains weak due to the lack of large, robust trials.

Indexed as

Self CareAdultAsthmaHumansQuality of LifeRandomized Controlled Trials as TopicTelemedicine

Identifiers

PMID27215329
PMCPMC4876566

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.