Self-management teaching programs and morbidity of pediatric asthma: A meta-analysis☆,☆☆,★
Section snippets
Search of studies
A literature search of all studies, in either English or French, published between 1970 and 1991, was performed with the key words asthma, education, and self-management programs. Studies were identified through searches of MEDLINE, Index Medicus, American Journal of Nursing International Index, Dissertation Abstracts Online Database, and the bibliography of retrieved studies. Authors of preliminary or pilot studies were contacted in an attempt to obtain further definitive results.
Inclusion criteria
Only
RESULTS
An initial literature search retrieved 106 references in which 23 studies were identified as clinical trials. A more extensive review excluded 12 studies for the following reasons. Three studies were not randomized,20, 21, 22 three studies evaluated a noninteractive teaching intervention consisting of a self-teaching booklet23, 24 or an audiovisual teaching aid,25 and six studies addressed outcomes not related to morbidity such as compliance,26 knowledge,27 attitudes,28, 29 or a combination of
DISCUSSION
This meta-analysis shows that self-management teaching programs have surprisingly little influence on morbidity outcomes. In the case of each morbidity variable, pooled effect size remained below 0.2, which we have already described as a small effect size.
We must emphasize that the number of clinical trials included in the meta-analysis was limited to 11 studies and that not all of the 11 studies addressed the five morbidity outcomes selected for the overview. Consequently, pooling of the
References (43)
The application of theory in childhood asthma self-help programs
J ALLERGY CLIN IMMUNOL
(1983)- et al.
Self-management psychology and the treatment of childhood asthma
J ALLERGY CLIN IMMUNOL
(1983) Review of asthma self-management programs
J ALLERGY CLIN IMMUNOL
(1987)- et al.
The impact of pediatric asthma education on morbidity: assessing the evidence
Chest
(1988) Asthma self-management education: research and implications for clinical practice
Chest
(1989)- et al.
A method for assessing the quality of a randomized control trial
Control Clin Trials
(1981) - et al.
The impact of a self-administered behavioral intervention program on pediatric asthma
Psychom Res
(1985) - et al.
The impact of health education on frequency and cost of health care use by low income children with asthma
J ALLERGY CLIN IMMUNOL
(1986) Bias in analytic research
J Chron Dis
(1979)- et al.
Impact of childhood asthma on health
Pediatrics
(1992)
School functioning of US children with asthma
Pediatrics
Changing patterns of asthma hospitalization among children: 1979 to 1987
JAMA
Trends in rates of admission to hospital and death from asthma among children and young adults in Canada during the 1980s
Can Med Assoc J
Workshop on asthma self-management: summary of workshop discussion
J ALLERGY CLIN IMMUNOL
Asthma self-management programs: premises, not promises
J Asthma
A critique of 19 self-management programs for childhood asthma. Part I. Development and evaluation of the programs
Ped Asthma Allerg Immunol
A critique of 19 self-management programs for childhood asthma. Part II. Comments regarding the scientific merit of the programs
Pediatr Asthma Allergy Immunol
The potential and limitations of meta-analysis
J Epidemiol Community Health
Why do we need systematic overviews of randomized trials?
Stat Med
Meta-analysis in primary care. Theory and practice
Parametric estimation of effect size from a series of experiments
Cited by (0)
- ☆
From athe Department of Pediatrics, University of Montreal; bthe Department of Social and Preventive Medicine, University of Montreal; and cHôpital Sainte-Justine, Department of Pediatrics, University of Montreal.
- ☆☆
Reprint requests: Anne-Claude Bernard-Bonnin, MD, FRCP(c), Département de Pédiatrie, Hôpital Sainte-Justine, 3175 Côte Sainte-Catherine, Montréal, Québec, Canada H3T 1C5.
- ★
0091-6749/95 $3.00 + 0 1/1/58677