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Chronic disease management programmes for adults with asthma.

Isabelle Peytremann-Bridevaux1, Chantal Arditi, Grégoire Gex

  • 1Cochrane Switzerland, Institute of Social and Preventive Medicine, Lausanne University Hospital, Biopôle 2, Route de la Corniche 10, Lausanne, Switzerland, CH-1010.

The Cochrane Database of Systematic Reviews
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Summary

Chronic disease management programmes for adults with asthma show moderate to low quality evidence of improving quality of life, asthma severity, and lung function. Further research is needed to determine optimal programme composition and added value compared to standard care.

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Area of Science:

  • Pulmonology
  • Healthcare Management
  • Evidence-Based Medicine

Background:

  • Asthma imposes a significant burden on patients and healthcare systems.
  • Chronic disease management programmes offer a structured approach beyond basic patient education.
  • These programmes integrate health services and emphasize patient self-management.

Purpose of the Study:

  • To evaluate the effectiveness of chronic disease management programmes for adults diagnosed with asthma.

Main Methods:

  • A systematic review and meta-analysis of randomized controlled trials, non-randomized controlled trials, and controlled before-after studies.
  • Searches conducted across multiple databases including CENTRAL, EPOC, MEDLINE, EMBASE, CINAHL, and PsycINFO up to June 2014.
  • Included studies involved adults over 16 with asthma, comparing chronic disease management programmes (minimum 3 months duration, multi-professional involvement) with usual care.

Main Results:

  • Twenty studies involving 81,746 patients were analyzed, with moderate to low methodological quality.
  • Chronic disease management programmes demonstrated improvements in asthma-specific quality of life (SMD 0.22), asthma severity scores (SMD 0.18), and lung function (SMD 0.19).
  • Data on self-efficacy were inconclusive, and results for hospitalizations and emergency visits were too heterogeneous for meta-analysis.

Conclusions:

  • Moderate to low quality evidence suggests chronic disease management programmes improve quality of life, asthma severity, and lung function in adults with asthma.
  • These programmes show potential effectiveness compared to usual care.
  • Further investigation is required to define optimal programme components and their comparative effectiveness against standalone education or self-management support.