Source: International Congress 2014 – Management of asthma and other respiratory diseases in primary care
Disease area: Airway diseases

Abstract

Aim: Asthma self-management is widely recommended by guidelines but poorly implemented. We undertook a systematic review of phase IV implementation studies of asthma self-management support interventions to inform implementation in real-life settings.Methods: We searched 7 electronic databases, and performed snowball and manual searches. We assessed all eligible papers for quality, extracted and synthesised data on process and clinical outcomes (e.g. asthma symptoms, use of health services).Results: 14 studies were included in the review. Complex whole systems interventions which addressed patient education, professional training and facilitated a supportive organisation were associated with improved asthma control. Individually, however, these core components were insufficient to reliably improve clinical outcomes. Key facilitators were commitment of the healthcare system to supporting self-management, self-management skills training for professionals, patient education programmes supported by regular reviews, good communication within multidisciplinary teams and on-going evaluation of implementation effectiveness.Conclusion: A supportive organisational culture underpins and enables integration of self-management principles into routine clinical care, such that the process and clinical impact of patient/professional interventions are realised.Funding: NIHR HS&DR programme (project number 11/1014/04).The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HS&DR programme, NIHR, NHS or the Department of Health.

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H. Pinnock, E. Epiphaniou, H. Parke, G. Parke, S. Taylor (Edinburgh, London, United Kingdom). Implementing asthma self-management – A systematic review of implementation studies. Eur Respir J 2014; 44: Suppl. 58, 3017

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