Evidence map›Paper›PMID 28302126›Full record

SynthesisBMC medicine2017

Systematic meta-review of supported self-management for asthma: a healthcare perspective.

Hilary Pinnock, Hannah L Parke, Maria Panagioti, Luke Daines, Gemma Pearce, Eleni Epiphaniou, Peter Bower, Aziz Sheikh, Chris J Griffiths, Stephanie J C Taylor and 1 more

Registry-linked trialOpen access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMC medicine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04810169 (Towards Participatory Paediatric Asthma Action Plans), which is not on this map. Cited by 162 papers, 16 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
162citing papers in PubMed, 16 pooled it
15.4field-weighted citation impact, top 1% of its field
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.

NCT04810169 completednot on this mapstarted 2021, after this paper: background citation

Towards Participatory Paediatric Asthma Action Plans

TypeobservationalSponsorAssistance Publique - Hôpitaux de ParisRan2021 to 2023Enrolled120ConditionsAsthmaArmsSmart inhaler
3 · Its place in the literature

Who cites it

162 citing papers in PubMed, 16 syntheses or guidelines pooled it, 287 citations in OpenAlex.

  1. Pooled it
  2. Home-based educational interventions for children with asthma.The Cochrane database of systematic reviews · 2025
    Pooled it
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  6. Delivery of supported self-management in remote asthma reviews: A systematic rapid realist review.Health expectations : an international journal of public participation in health care and health policy · 2022
    Pooled it
  7. Pooled it
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  12. IMPNPJ primary care respiratory medicine · 2018
    Pooled it
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  17. Trial
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102 more citing papers are in PubMed but not listed here.

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

11 authors at 3 institutions in 1 country.

Hilary PinnockAsthma UK Centre for Applied Research, Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Doorway 3, Medical School, Teviot Place, Edinburgh, EH8 9AG, UK. hilary.pinnock@ed.ac.uk.
Hannah L ParkeCentre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Maria PanagiotiNIHR School for Primary Care Research, Centre for Primary Care, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
Luke DainesAsthma UK Centre for Applied Research, Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Doorway 3, Medical School, Teviot Place, Edinburgh, EH8 9AG, UK.
Gemma PearceCentre for Technology Enabled Health Research (CTEHR), Coventry University, Coventry, UK.
Eleni EpiphaniouCentre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Peter BowerNIHR School for Primary Care Research, Centre for Primary Care, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK.
Aziz SheikhAsthma UK Centre for Applied Research, Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Doorway 3, Medical School, Teviot Place, Edinburgh, EH8 9AG, UK.
Chris J GriffithsCentre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
Stephanie J C TaylorCentre for Primary Care and Public Health, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
PRISMS and RECURSIVE groups
Queen Mary University of London · GBAsthma UK · GBManchester Academic Health Science Centre · GB

Funding

Chief Scientist Office PCRCA/08/01Department of Health 11/1014/04Department of Health 11/1014/06Department of Health RP-DG-1213-10008Medical Research Council G1000758
6 · The paper itself

Abstract

backgroundSupported self-management has been recommended by asthma guidelines for three decades; improving current suboptimal implementation will require commitment from professionals, patients and healthcare organisations. The Practical Systematic Review of Self-Management Support (PRISMS) meta-review and Reducing Care Utilisation through Self-management Interventions (RECURSIVE) health economic review were commissioned to provide a systematic overview of supported self-management to inform implementation. We sought to investigate if supported asthma self-management reduces use of healthcare resources and improves asthma control; for which target groups it works; and which components and contextual factors contribute to effectiveness. Finally, we investigated the costs to healthcare services of providing supported self-management.

methodsWe undertook a meta-review (systematic overview) of systematic reviews updated with randomised controlled trials (RCTs) published since the review search dates, and health economic meta-analysis of RCTs. Twelve electronic databases were searched in 2012 (updated in 2015; pre-publication update January 2017) for systematic reviews reporting RCTs (and update RCTs) evaluating supported asthma self-management. We assessed the quality of included studies and undertook a meta-analysis and narrative synthesis.

resultsA total of 27 systematic reviews (n = 244 RCTs) and 13 update RCTs revealed that supported self-management can reduce hospitalisations, accident and emergency attendances and unscheduled consultations, and improve markers of control and quality of life for people with asthma across a range of cultural, demographic and healthcare settings. Core components are patient education, provision of an action plan and regular professional review. Self-management is most effective when delivered in the context of proactive long-term condition management. The total cost (n = 24 RCTs) of providing self-management support is offset by a reduction in hospitalisations and accident and emergency visits (standard mean difference 0.13, 95% confidence interval -0.09 to 0.34).

conclusionsEvidence from a total of 270 RCTs confirms that supported self-management for asthma can reduce unscheduled care and improve asthma control, can be delivered effectively for diverse demographic and cultural groups, is applicable in a broad range of clinical settings, and does not significantly increase total healthcare costs. Informed by this comprehensive synthesis of the literature, clinicians, patient-interest groups, policy-makers and providers of healthcare services should prioritise provision of supported self-management for people with asthma as a core component of routine care. SYSTEMATIC REVIEW REGISTRATION: RECURSIVE: PROSPERO CRD42012002694 ; PRISMS: PROSPERO does not register meta-reviews.

Indexed as

AsthmaDelivery of Health CareHealth Care CostsHospitalizationHumansQuality of LifeSelf CareAsthmaHealth economic analysisMeta-analysisSupported self-managementSystematic meta-review

Identifiers

PMID28302126
PMCPMC5356253
OpenAlexW2594148781

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

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.