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Psychological interventions for adults with asthma

Yorke, J, Fleming , SL and Shuldham, C 2009, 'Psychological interventions for adults with asthma' , Cochrane Database of Systematic Reviews (1) .

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Abstract

Background Many people have asthma, and for some their symptoms may be triggered by psychological factors. In addition, compliance with medical therapy may have a psychological dimension. Therefore, psychological interventions aim to reduce the burden of symptoms and improve management of the disease. Objectives To assess the effectiveness of psychological interventions for adults with asthma. Search strategy The Cochrane Airways Group Specialised Register and PsycINFO were searched with pre-defined terms up until May 2007. Selection criteria Randomised controlled trials published in any language assessing the effects of a psychological intervention compared with a form of control in adult participants were included in the review. Our primary outcome was healthcare resource defined as: hospitalisation, emergency room visits and/or GP visits Data collection and analysis Two reviewers assessed the relevance of abstracts identified by electronic searching and retrieved agreed studies for further scrutiny. The studies that met the inclusion criteria were assembled and data extracted. Main results Fifteen studies, involving 687 participants, were included in the review. Study quality was poor and sample sizes were frequently small. However, some pooled effects were analysed. Three studies measured our primary outcome but individually did not report significant differences between treatment and control. The use of 'as needed' medications was reduced in two studies, (47 patients), by relaxation therapy (OR 4.47, CI 1.22 to 16.44). There was no significant difference in FEV1 for relaxation therapy in four studies of 150 patients, (SMD -0.01, CI -0.41 to 0.40). Quality of life, measured using the Asthma Quality of Life Questionnaire in two studies, (48 patients), showed a positive effect following CBT (WMD 0.71, CI 0.23 to 1.19). Peak Expiratory Flow outcome data in two studies, (51 patients), indicated a significant difference in favour of bio-feedback therapy (SMD 0.66, CI 0.09 to 1.23) but no significant difference following relaxation therapy (WMD 43 L/min, CI -5 to 92 L/min). There was no statistically significant improvement in depression levels following relaxation therapy (SMD 0.17, CI -0.25 to 0.59). The remainder of the findings between studies were conflicting. This may have been due to the different types of interventions used and the deficiencies in trial design. Authors' conclusions This review was unable to draw firm conclusions for the role of psychological interventions in asthma due to the absence of an adequate evidence base. Larger, well-conducted and reported randomised trials are required in this area, in order to determine the effects of these techniques in the treatment of asthma in adults.

Item Type: Article
Themes: Subjects / Themes > R Medicine > R Medicine (General)
Health and Wellbeing
Schools: Colleges and Schools > College of Health & Social Care > School of Nursing, Midwifery, Social Work & Social Sciences > Centre for Nursing, Midwifery & Social Work Research
Colleges and Schools > College of Health & Social Care
Colleges and Schools > College of Health & Social Care > School of Nursing, Midwifery, Social Work & Social Sciences
Journal or Publication Title: Cochrane Database of Systematic Reviews
Publisher: Wiley-Blackwell
Refereed: Yes
ISSN: 1469-493X
Depositing User: Users 29196 not found.
Date Deposited: 07 May 2010 11:32
Last Modified: 20 Aug 2013 17:16
URI: http://usir.salford.ac.uk/id/eprint/8833

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