Community-based interventions for childhood asthma using comprehensive approaches: a systematic review and meta-analysis
Abstract 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 Lite...
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doaj-44d2263112404c4dac0a37d7875480412021-02-21T12:24:08ZengBMCAllergy, Asthma & Clinical Immunology1710-14922021-02-0117111610.1186/s13223-021-00522-9Community-based interventions for childhood asthma using comprehensive approaches: a systematic review and meta-analysisMei Chan0Melinda Gray1Christine Burns2Louisa Owens3Susan Woolfenden4Raghu Lingam5Adam Jaffe6Nusrat Homaira7Discipline of Paediatrics, School of Women’s and Children’s Health, Faculty of Medicine, University of New South WalesRespiratory Department, Sydney Children’s HospitalRespiratory Department, Sydney Children’s HospitalDiscipline of Paediatrics, School of Women’s and Children’s Health, Faculty of Medicine, University of New South WalesDiscipline of Paediatrics, School of Women’s and Children’s Health, Faculty of Medicine, University of New South WalesDiscipline of Paediatrics, School of Women’s and Children’s Health, Faculty of Medicine, University of New South WalesDiscipline of Paediatrics, School of Women’s and Children’s Health, Faculty of Medicine, University of New South WalesDiscipline of Paediatrics, School of Women’s and Children’s Health, Faculty of Medicine, University of New South WalesAbstract 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.https://doi.org/10.1186/s13223-021-00522-9Community-basedMeta-analysisAsthmaChildhoodComprehensive intervention |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Mei Chan Melinda Gray Christine Burns Louisa Owens Susan Woolfenden Raghu Lingam Adam Jaffe Nusrat Homaira |
spellingShingle |
Mei Chan Melinda Gray Christine Burns Louisa Owens Susan Woolfenden Raghu Lingam Adam Jaffe Nusrat Homaira Community-based interventions for childhood asthma using comprehensive approaches: a systematic review and meta-analysis Allergy, Asthma & Clinical Immunology Community-based Meta-analysis Asthma Childhood Comprehensive intervention |
author_facet |
Mei Chan Melinda Gray Christine Burns Louisa Owens Susan Woolfenden Raghu Lingam Adam Jaffe Nusrat Homaira |
author_sort |
Mei Chan |
title |
Community-based interventions for childhood asthma using comprehensive approaches: a systematic review and meta-analysis |
title_short |
Community-based interventions for childhood asthma using comprehensive approaches: a systematic review and meta-analysis |
title_full |
Community-based interventions for childhood asthma using comprehensive approaches: a systematic review and meta-analysis |
title_fullStr |
Community-based interventions for childhood asthma using comprehensive approaches: a systematic review and meta-analysis |
title_full_unstemmed |
Community-based interventions for childhood asthma using comprehensive approaches: a systematic review and meta-analysis |
title_sort |
community-based interventions for childhood asthma using comprehensive approaches: a systematic review and meta-analysis |
publisher |
BMC |
series |
Allergy, Asthma & Clinical Immunology |
issn |
1710-1492 |
publishDate |
2021-02-01 |
description |
Abstract 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. |
topic |
Community-based Meta-analysis Asthma Childhood Comprehensive intervention |
url |
https://doi.org/10.1186/s13223-021-00522-9 |
work_keys_str_mv |
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