Community-based interventions for childhood asthma using comprehensive approaches: a systematic review and meta-analysis.

Tytuł:: Community-based interventions for childhood asthma using comprehensive approaches: a systematic review and meta-analysis.
Autorzy:: Chan M; Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2031, Australia.
Gray M; Respiratory Department, Sydney Children's Hospital, Randwick, NSW 2031, Australia.
Burns C; Respiratory Department, Sydney Children's Hospital, Randwick, NSW 2031, Australia.
Owens L; Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2031, Australia.; Respiratory Department, Sydney Children's Hospital, Randwick, NSW 2031, Australia.
Woolfenden S; Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2031, Australia.; Respiratory Department, Sydney Children's Hospital, Randwick, NSW 2031, Australia.
Lingam R; Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2031, Australia.; Respiratory Department, Sydney Children's Hospital, Randwick, NSW 2031, Australia.
Jaffe A; Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2031, Australia.; Respiratory Department, Sydney Children's Hospital, Randwick, NSW 2031, Australia.
Homaira N; Discipline of Paediatrics, School of Women's and Children's Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, 2031, Australia. .; Respiratory Department, Sydney Children's Hospital, Randwick, NSW 2031, Australia. .
Źródło:: Allergy, asthma, and clinical immunology : official journal of the Canadian Society of Allergy and Clinical Immunology [Allergy Asthma Clin Immunol] 2021 Feb 15; Vol. 17 (1), pp. 19. Date of Electronic Publication: 2021 Feb 15.
Typ publikacji:: Journal Article; Review
Język:: English
Imprint Name(s):: Publication: Oct. 2009- : London : BioMed Central
Original Publication: Hamilton, Ont. : BC Decker, c2004-
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Contributed Indexing:: Keywords: Asthma; Childhood; Community-based; Comprehensive intervention; Meta-analysis
Entry Date(s):: Date Created: 20210216 Latest Revision: 20210223
Update Code:: 20240104
PubMed Central ID:: PMC7885565
DOI:: 10.1186/s13223-021-00522-9
PMID:: 33588934
: Czasopismo naukowe

Pełny tekst

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.

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