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Nonpharmacological interventions aimed at modifying health and behavioural outcomes for adults with asthma: a critical review
Author(s) -
Yorke J.,
Fleming S.,
Shuldham C.,
Rao H.,
Smith H.E.
Publication year - 2015
Publication title -
clinical and experimental allergy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.462
H-Index - 154
eISSN - 1365-2222
pISSN - 0954-7894
DOI - 10.1111/cea.12511
Subject(s) - psychological intervention , medicine , asthma , randomized controlled trial , mindfulness , systematic review , medline , meta analysis , quality of life (healthcare) , physical therapy , clinical trial , cognitive therapy , biofeedback , clinical psychology , intensive care medicine , psychiatry , nursing , political science , law
Summary Evidence suggests that living with asthma is linked with psychological and behavioural factors including self‐management and treatment adherence, and therefore, there is a reasonable hypothesis that nonpharmacological treatments may improve health outcomes in people living with this condition. A systematic review of randomized controlled trials (RCTs) of nonpharmacological interventions for adults with asthma was designed. Databases searched included The Cochrane Airways Group Register of trials, CENTRAL and Psychinfo. The literature search was conducted until May 2014. Twenty‐three studies met the inclusion criteria and were organized into four groups: relaxation‐based therapies ( n = 9); mindfulness ( n = 1), biofeedback techniques ( n = 3); cognitive behavioural therapies ( CBT ) ( n = 5); and multicomponent interventions ( n = 5). A variety of outcome measures were used, even when trials belonged to the same grouping, which limited the ability to conduct meaningful meta‐analyses. Deficiencies in the current evidence base, notably trial heterogeneity, means that application to clinical practice is limited and clear guidelines regarding the use of nonpharmacological therapies in asthma is limited. Relaxation and CBT , however, appear to have a consistent positive effect on asthma‐related quality of life and some psychological outcomes, and lung function (relaxation only). Future trials should be informed by previous work to harmonize the interventions under study and outcome measures used to determine their effectiveness; only then will meaningful meta‐analyses inform clinical practice.