Table 36Asthma: strength of evidence for education and self-management interventions

InterventionNumber of Studies; Subjects (Analyzed)OutcomeStudy Design/
Risk of Bias
ConsistencyDirectnessPrecisionMagnitude of Effect and Strength of Evidence
Asthma education and self-management vs. usual care5; 303 (300)Medication adherenceRCT
Medium
ConsistentDirectPreciseDifference in percentage points for adherence: 14 to 31 (range)
Moderate for benefit for duration of intervention
Insufficient for longer-term effects
2; 152 (149)Pulmonary functionRCT
Medium
ConsistentIndirectImpreciseInsufficient
2; 152 (149)Inflammation markersRCT
Medium
InconsistentIndirectImpreciseInsufficient
5; 303 (300)Symptom improvementRCT
Medium
Inconsistent (trend to improvement sometimes favors intervention arm and sometimes control arm)DirectImpreciseVaried measures and magnitude

Insufficient
4; 248 (245)Quality of lifeRCT
Medium
ConsistentDirectImpreciseVaried measures and magnitude
Low for no benefit

Abbreviation: RCT = randomized controlled trial.

From: Results

Cover of Closing the Quality Gap: Revisiting the State of the Science (Vol. 4: Medication Adherence Interventions: Comparative Effectiveness)
Closing the Quality Gap: Revisiting the State of the Science (Vol. 4: Medication Adherence Interventions: Comparative Effectiveness).
Evidence Reports/Technology Assessments, No. 208.4.
Viswanathan M, Golin CE, Jones CD, et al.

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