Review: regular medical review is not better than written self management plans for optimising asthma control
QUESTIONS: Is regular medical review (RMR) better than written self management plans for optimising asthma control in adults with asthma who use inhaled corticosteroids? Do health outcomes differ for written self management plans based on peak expiratory flow self management (PFSM) and those based on symptom self monitoring (SSM)?
Studies were identified by searching the Cochrane Airways Group Special Register of Controlled Trials (which comprises results of searching Medline, EMBASE/Excerpta Medica, and CINAHL), and reviewing bibliographies of relevant articles.
Studies were selected if they were randomised controlled trials (RCTs) of ≥2 self management asthma education interventions in adult patients with asthma who were >16 years of age, and reported relevant health outcomes.
2 reviewers independently extracted data on sample size, demographic characteristics, details of the intervention, setting, study quality, and outcomes. Outcomes included forced expiratory volume in 1 second (FEV1), peak expiratory flow, hospital admissions, emergency department visits, unscheduled doctor visits, days lost from work or school, and use of rescue medications.
15 RCTs (2460 patients) met the selection criteria. Meta-analyses were done using a fixed effects model. Primary comparisons included optimal self management with RMR (6 RCTs) comparing 2 …