Barriers and facilitators of effective self-management in asthma: systematic review and thematic synthesis of patient and healthcare professional views
Open accessAbstract
Self-management is an established, effective approach to controlling asthma, recommended in guidelines. However, promotion, uptake and use among patients and health-care professionals remain low. Many barriers and facilitators to effective self-management have been reported, and views and beliefs of patients and health care professionals have been explored in qualitative studies. We conducted a systematic review and thematic synthesis of qualitative research into self-management in patients, carers and health care professionals regarding self-management of asthma, to identify perceived barriers and facilitators associated with reduced effectiveness of asthma self-management interventions. Electronic databases and guidelines were searched systematically for qualitative literature that explored factors relevant to facilitators and barriers to uptake, adherence, or outcomes of self-management in patients with asthma. Thematic synthesis of the 56 included studies identified 11 themes: (1) partnership between patient and health care professional; (2) issues around medication; (3) education about asthma and its management; (4) health beliefs; (5) self-management interventions; (6) co-morbidities (7) mood disorders and anxiety; (8) social support; (9) non-pharmacological methods; (10) access to healthcare; (11) professional factors. From this, perceived barriers and facilitators were identified at the level of individuals with asthma (and carers), and health-care professionals. Future work addressing the concerns and beliefs of adults, adolescents and children (and carers) with asthma, effective communication and partnership, tailored support and education (including for ethnic minorities and at risk groups), and telehealthcare may improve how self-management is recommended by professionals and used by patients. Ultimately, this may achieve better outcomes for people with asthma.
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Young patients still face problems related to both cognitive and behavioral skills that hinder their ability to effectively administer asthma medications.
“However, young patients still face problems related to both cognitive and behavioral skills that hinder their ability to effectively administer asthma medications [30-35].”
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- Authors
- Miles, C., Arden-Close, E., Thomas, M., Bruton, A., Yardley, L., Hankins, M., & Kirby, S. E.
- Affiliations
- University of Southampton (GB)
- Bournemouth University (GB)
- NIHR Southampton Respiratory Biomedical Research Unit (GB)
- Corresponding author
- Kirby, Sarah E.
- Venue
- npj Primary Care Respiratory Medicine
- Published
- 2017-10-09
- Volume
- 27
- Issue
- 1
- Pages
- 57-57
- ISSN
- 2055-1010 (ISSN-L)
- PMC
- PMC5634481
- OpenAlex
- W2757464582
- Cited by
- 153
- References
- 85
- Citations by year
- 2026: 9 · 2025: 12 · 2024: 25 · 2023: 23 · 2022: 19 · 2021: 20 · 2020: 15 · 2019: 23 · 2018: 5 · 2016: 2
- FWCI
- 1.44
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- npj Primary Care Respiratory Medicine (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Explore Bristol Research (publishedVersion, cc-by)
- Bournemouth University Research Online (Bournemouth University) (acceptedVersion)
- ePrints Soton (University of Southampton) (acceptedVersion)
- Bristol Research (University of Bristol) (submittedVersion, cc-by)
- Funders
- National Institute for Health and Care Research (SRF-2012-05-120)
- Asthma and Lung UK
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational exposure and asthma
- Keywords
- asthma, self-management, barriers and facilitators, patient-provider partnership, asthma education, health beliefs, medication adherence, social support, comorbidities, mood disorders, anxiety, health care access, telemedicine, caregivers
- MeSH terms
- Self-Management, Asthma, Attitude of Health Personnel, Attitude to Health, Health Personnel, Humans, Treatment Outcome
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