A systematic review of interventions addressing limited health literacy to improve asthma self-management.
Journal
Journal of global health
ISSN: 2047-2986
Titre abrégé: J Glob Health
Pays: Scotland
ID NLM: 101578780
Informations de publication
Date de publication:
Jun 2020
Jun 2020
Historique:
entrez:
23
6
2020
pubmed:
23
6
2020
medline:
5
3
2021
Statut:
ppublish
Résumé
Supported asthma self-management improves health outcomes. However, people with limited health literacy, especially in lower-middle-income countries (LMICs), may need tailored interventions to enable them to realise the benefits. We aimed to assess the clinical effectiveness of asthma self-management interventions targeted at people with limited health literacy and to identify strategies associated with effective programmes. Following Cochrane methodology, we searched ten databases (January 1990 - June 2018; updated October 2019), without language restriction. We included controlled experimental studies whose interventions targeted health literacy to improve asthma self-management. Selection of papers, extraction of data and quality assessment were done independently by two reviewers. The primary outcomes were clinical (asthma control) and implementation (adoption/adherence to intervention). Analysis was narrative. We screened 4318 titles and abstracts, reviewed 52 full-texts and included five trials. One trial was conducted in a LMIC. Risk of bias was low in one trial and high in the other four studies. Clinical outcomes were reported in two trials, both at high risk of bias: one of which reported a reduction in unscheduled care (number of visits in 6-month (SD); Intervention:0.9 (1.2) vs Control:1.8 (2.4), The paucity of studies and diversity of the interventions to support people with limited health literacy to self-manage their asthma meant that the impact on health outcomes remains unclear. Given the proportion of the global population who have limited health literacy skills, this is a research priority. PROSPERO CRD 42018118974.
Sections du résumé
BACKGROUND
BACKGROUND
Supported asthma self-management improves health outcomes. However, people with limited health literacy, especially in lower-middle-income countries (LMICs), may need tailored interventions to enable them to realise the benefits. We aimed to assess the clinical effectiveness of asthma self-management interventions targeted at people with limited health literacy and to identify strategies associated with effective programmes.
METHODS
METHODS
Following Cochrane methodology, we searched ten databases (January 1990 - June 2018; updated October 2019), without language restriction. We included controlled experimental studies whose interventions targeted health literacy to improve asthma self-management. Selection of papers, extraction of data and quality assessment were done independently by two reviewers. The primary outcomes were clinical (asthma control) and implementation (adoption/adherence to intervention). Analysis was narrative.
RESULTS
RESULTS
We screened 4318 titles and abstracts, reviewed 52 full-texts and included five trials. One trial was conducted in a LMIC. Risk of bias was low in one trial and high in the other four studies. Clinical outcomes were reported in two trials, both at high risk of bias: one of which reported a reduction in unscheduled care (number of visits in 6-month (SD); Intervention:0.9 (1.2) vs Control:1.8 (2.4),
CONCLUSIONS
CONCLUSIONS
The paucity of studies and diversity of the interventions to support people with limited health literacy to self-manage their asthma meant that the impact on health outcomes remains unclear. Given the proportion of the global population who have limited health literacy skills, this is a research priority.
PROTOCOL REGISTRATION
BACKGROUND
PROSPERO CRD 42018118974.
Identifiants
pubmed: 32566166
doi: 10.7189/jogh.10.010428
pii: jogh-10-010428
pmc: PMC7298737
doi:
Types de publication
Journal Article
Systematic Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
010427Informations de copyright
Copyright © 2020 by the Journal of Global Health. All rights reserved.
Déclaration de conflit d'intérêts
Competing interest: The authors have completed the ICMJE Unified Competing Interest form (available on request from the corresponding author) and declare no conflict of interest.
Références
J Health Commun. 2010;15 Suppl 2:211-23
pubmed: 20845205
BMC Public Health. 2013 Oct 10;13:948
pubmed: 24112855
J Allergy Clin Immunol. 2004 Jan;113(1):59-65
pubmed: 14713908
NPJ Prim Care Respir Med. 2019 May 8;29(1):18
pubmed: 31068584
J Asthma. 2012 Jun;49(5):542-51
pubmed: 22715910
BMJ. 2008 Sep 29;337:a1655
pubmed: 18824488
Addiction. 2004 Sep;99(9):1083-9
pubmed: 15317624
J Immigr Minor Health. 2011 Apr;13(2):315-22
pubmed: 20938742
Eur Respir J. 1999 Oct;14(4):902-7
pubmed: 10573240
BMJ. 2014 Mar 07;348:g1687
pubmed: 24609605
J Allergy Clin Immunol. 2011 Sep;128(3):516-23.e1-5
pubmed: 21704360
BMJ. 2008 May 17;336(7653):1106-10
pubmed: 18483053
Soc Sci Med. 2015 Apr;131:10-7
pubmed: 25748110
Soc Sci Med. 2010 Mar;70(5):769-78
pubmed: 20005617
Pediatr Emerg Care. 2011 Jun;27(6):469-74
pubmed: 21629152
Implement Sci. 2011 Apr 23;6:42
pubmed: 21513547
Am J Respir Crit Care Med. 2009 Jul 1;180(1):59-99
pubmed: 19535666
Am J Respir Crit Care Med. 2005 Oct 15;172(8):980-6
pubmed: 16081544
J Asthma. 2017 Nov;54(9):919-929
pubmed: 28045551
BMC Med. 2017 Mar 17;15(1):64
pubmed: 28302126
BMC Med Res Methodol. 2008 Feb 25;8:8
pubmed: 18298827
Implement Sci. 2017 Feb 23;12(1):25
pubmed: 28231840
J Gen Intern Med. 2018 Apr;33(4):510-523
pubmed: 29427178
BMC Med. 2015 Jun 01;13:127
pubmed: 26032941
BMJ Open. 2017 Aug 11;7(8):e015637
pubmed: 28801403
J Health Commun. 2011;16 Suppl 3:30-54
pubmed: 21951242
Am J Health Behav. 2007 Sep-Oct;31 Suppl 1:S19-26
pubmed: 17931132
BMJ. 2000 Sep 16;321(7262):694-6
pubmed: 10987780
J Asthma. 2014 May;51(4):423-8
pubmed: 24200510
J Natl Med Assoc. 2008 Aug;100(8):892-6
pubmed: 18717138
Glob Health Action. 2015 Oct 23;8:29067
pubmed: 26498744
J Community Health. 2009 Aug;34(4):321-7
pubmed: 19353250
BMC Public Health. 2012 Jan 25;12:80
pubmed: 22276600
J Health Serv Res Policy. 2016 Apr;21(2):73-82
pubmed: 26377727