Could a behaviour change intervention be used to address under-recognition of work-related asthma in primary care? A...

Work-related asthma (WRA) is prevalent yet under-recognised in UK primary care.

To identify behaviour change interventions (BCIs) intended for use in primary care to identify WRA, or any other chronic disease (that could be adapted for use in WRA).

A systematic review was conducted using narrative synthesis.

We searched Cochrane Central Register of Controlled Trials, Embase, PsycINFO, and Ovid MEDLINE databases (1946-2023) for studies describing development and/or evaluation of BCIs for case finding any chronic disease in primary care settings, aimed at either healthcare professionals and/or patients. Two blinded, independent reviewers screened abstracts and assessed full-text articles. We undertook narrative synthesis for outcomes of usability and effectiveness, and for BCI development processes.

We included 14 studies from 768 retrieved citations, comprising three randomised controlled trials, one uncontrolled experimental study, and 10 studies employing recognised multi-step behaviour change (BC) methodologies. None of the studies were concerned with identification of asthma. BCIs had been developed for facilitating screening programmes (five studies), implementing guidelines (three studies), and individual case finding (six studies). Five studies measured effectiveness, in terms of screening adherence rates, pre- or post-intervention competency, and satisfaction and usability, for clinicians, although none measured diagnostic rates.

No single or multi-component BCIs have been developed specifically to aid identification of asthma or WRA, although other chronic diseases have been targeted. Development has used BC methodologies that involved gathering data from a range of sources, and developing content specific to defined at-risk populations, so are not immediately transferable. Such methodologies could be used similarly to develop a primary care-based BCI for WRA.