PRISMS: A systematic meta-review of the evidence on supporting asthma self-management

Aim: To inform practical implementation of asthma self-management, we synthesised the findings of systematic reviews to provide a high-level overview. Methods: We systematically searched 7 electronic databases plus snowball and manual searches. Outcomes of interest: measures of asthma control, asthma-related quality of life. We investigated the composition, delivery, and setting of interventions in order to identify the optimal configuration of self-management support. Results: We included 18 systematic reviews (published 1995 – 2012) incorporating 157 randomised controlled trials. There is strong evidence that optimal self-management support (including a written action plan) reduces admissions and emergency department visits and increases quality of life in people with asthma. Interventions were diverse targeting healthcare professionals, patients and/or caregivers. Effective interventions were often tailored to specific populations (e.g. age, ethnicity, severity of disease) or to the context (e.g. in healthcare, school, or home settings) or mode of delivery (e.g. group, individual, telephone, computer) Conclusion: When developing self-management support services, it is essential to consider not only the content of the intervention, but also tailor the delivery mode and setting for the population and the healthcare context. Funding: NIHR HS&DR programme (project number 11/1014/04). The views and opinions expressed therein are those of the authors and do not necessarily reflect those of the HS&DR programme, NIHR, NHS or the Department of Health.