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Table 6 Focused data extraction from additional studies identified by forward citation prior to publication

From: Systematic meta-review of supported self-management for asthma: a healthcare perspective

Reference; RCTs, n; Participants, n; Date range RCTs Comparison Relevance to meta-review questions: Interventions included Target group(s) Synthesis Main results
What is the impact?
Target groups?
Which components?
Context?
Systematic reviews
Coelho 2016 [61]
17 RCTs; 5879 participants
RCTs 2005–2013
School-based asthma education vs. usual care.
FU: minimum 1 mo
Target: Schoolchildren Educational interventions to individuals, groups or classes by healthcare professionals, teachers, educators and/or IT. Schoolchildren with asthma and/or whole school. Narrative analysis 6/17 showed a reduction in unscheduled care; 5/17 showed a reduction of the asthma symptoms; 5/17 reduced school absenteeism; 7/17 improved QoL of the individuals; 8/17 showed that asthma education improved knowledge.
McLean 2016 [62]
5 RCTs
595 participants
RCTs 2011–2013
Interactive digital interventions vs. usual care.
FU: 10 weeks to 12 mo
Impact Components: Technology-based interventions Interactive intervention (i.e. entering data, receiving tailored feedback, making choices) accessed through an app that provides self-management information. Adults (≥16 y) with asthma. Meta-analysis Meta-analyses (3 studies) showed no significant difference in asthma control (SMD 0.21, 95% CI −0.05 to 0.42) or asthma QoL (SMD 0.05, 95% CI −0.22 to 0.32) but heterogeneity was very high.
Removal of the outlier study reduced heterogeneity and indicated significant improvement for both asthma control (SMD 0.54, 95% CI 0.22–0.86) and asthma QoL (SMD 0.45, 95% CI 0.13–0.77).
Randomised trials
Hoskins 2016 [63]
48 participants
Goal-setting + SM/PAAPs vs. usual care. Components: Goal-setting Practice asthma nurses trained in goal-setting approach. Primary care patients due a review. Cluster feasibility RCT. FU: 6 mo Difficulty recruiting: 10/124 practices participated and 48 patients. No between-group difference in QoL [mAQLQ I: 6.20 (SD 0.76, 95% CI 5.76–6.65) vs. C: 6.1 (SD 0.81, 95% CI 5.63–6.57), MD 0.1].
Morawska 2016 [64]
107 participants
Generic parenting skills vs usual care. Components: Parenting skills Parenting skills for managing LTCs + asthma ‘take-home tips sheets’. Parents of children 2–10 y with asthma and/or eczema. RCT. FU: 6 mo Between-group improvement in parents’ self-efficacy and childs’ ‘eczema behaviour’, but not equivalent asthma outcomes.
Parent and family generic QoL improved (p = 0.01).
Plaza 2015 [65]
230 participants
Trained practices (I) vs. specialist unit (Is) vs. usual care (C). Impact:
Components: Education programme
Basic information on asthma, inhaler technique; provision of a PAAP. Adults with persistent asthma. Cluster RCT. FU: 12 mo I groups had fewer unscheduled visits [I: 0.8 (SD 1.4) and Is: 0.3 (SD 0.7) vs. C:1.3 (SD 1.7); p = 0.001], and greater improvements in asthma control (p = 0.042) and QoL (p = 0.019).
Rice 2015 [66]
711 participants
PAAP + inpatient lay educator vs. PAAP. Components: Inpatient lay educator Encourage FU attendance, build self-efficacy, set goals, overcome barriers. Children 2–17 y admitted with asthma. RCT.
FU: 1 mo
No difference in attendance at FU appointment. I group had greater preventer use (OR 2.4, 95% CI 1.3–4.2), PAAP ownership (OR 2.0, 95% CI 1.3–3.0) and improved self-efficacy (p = 0.04).
Yeh 2016 [67]
76 participants
Family programme (+PAAP) vs. usual care (+PAAP). Components: Family empowerment Family empowerment to reduce parental stress, increase family functioning. Children 6–12 y with asthma. RCT.
FU: 3 mo
I families had reduced parental stress index (p = 0.026) and improved family environment scores (p < 0.0001), improved lung function, less disturbed sleep, less cough but no difference in wheeze.
Zairina 2016 [68]
72 participants
Telehealth supported PAAP vs. usual care. Components: Telehealth Telehealth (FEV1, symptoms) monitored weekly. Pregnant women with moderate/severe asthma RCT.
FU: 6 mo
Telehealth improved ACQ [MD 0.36 (SD 0.15, 95% CI −0.66 to −0.07)] and mAQLQ [MD 0.72 (SD 0.22; 95% CI 0.29–1.16)].
No difference in perinatal outcomes.
  1. Abbreviations: ACQ Asthma Control Questionnaire, AQLQ Asthma Quality Of Life Questionnaire, C control, CI confidence interval, FEV 1 forced expiratory volume in one second, FU follow-up, I intervention, LTC long-term condition, mAQAL mini Asthma Quality Of Life Questionnaire, MD mean difference, mo month, OR odds ratio, PAAP personalised asthma action plan, QoL quality of life, RCT randomised controlled trial, SD standard deviation, SMD standardised mean difference, y year