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Bronchial Thermoplasty: A Novel Therapeutic Approach to Severe Asthma
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Shared decision-making for people with asthma.

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Shared decision-making (SDM) may improve asthma management for children and adults. While some studies show benefits in quality of life and medication adherence, overall conclusions are limited by trial heterogeneity.

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Area of Science:

  • Pulmonology
  • Health Services Research
  • Patient-Centered Care

Background:

  • Asthma is a prevalent chronic airway inflammatory disease affecting adults and children.
  • Symptoms include wheezing, shortness of breath, chest tightness, and cough.
  • Shared decision-making (SDM) can aid asthma management by involving patients in treatment choices.

Purpose of the Study:

  • To evaluate the benefits and potential harms of SDM for adults and children with asthma.
  • To synthesize evidence from randomized controlled trials on SDM interventions in asthma care.

Main Methods:

  • Searched major databases (Cochrane Airways, CENTRAL, MEDLINE, Embase) and trial registries.
  • Included parallel randomized controlled trials comparing SDM interventions with control interventions for asthma patients.
  • Extracted data on primary outcomes (quality of life, satisfaction, adherence) and secondary outcomes (exacerbations, control, adverse events).

Main Results:

  • Four RCTs with 1342 participants were included; three in children, one in adults.
  • One study showed improved quality of life in adults with asthma using SDM.
  • SDM showed benefits in patient satisfaction, medication adherence, and reduced healthcare visits in some studies, but results were heterogeneous.

Conclusions:

  • Significant heterogeneity among the four RCTs prevents definitive overall conclusions.
  • Individual studies suggest potential benefits of SDM for asthma quality of life, satisfaction, and adherence.
  • Future trials need adequate power, duration, and standardized outcome reporting, including adverse events and adolescent populations.