Nonpharmacological interventions aimed at modifying health and behavioural outcomes for adults with asthma: a critical review
Abstract
Summary: Evidence suggests that living with asthma is linked with psychological and behavioural factors including self‐management and treatment adherence, and therefore, there is a reasonable hypothesis that nonpharmacological treatments may improve health outcomes in people living with this condition. A systematic review of randomized controlled trials (RCTs) of nonpharmacological interventions for adults with asthma was designed. Databases searched included The Cochrane Airways Group Register of trials, CENTRAL and Psychinfo. The literature search was conducted until May 2014. Twenty‐three studies met the inclusion criteria and were organized into four groups: relaxation‐based therapies (n = 9); mindfulness (n = 1), biofeedback techniques (n = 3); cognitive behavioural therapies (CBT) (n = 5); and multicomponent interventions (n = 5). A variety of outcome measures were used, even when trials belonged to the same grouping, which limited the ability to conduct meaningful meta‐analyses. Deficiencies in the current evidence base, notably trial heterogeneity, means that application to clinical practice is limited and clear guidelines regarding the use of nonpharmacological therapies in asthma is limited. Relaxation and CBT, however, appear to have a consistent positive effect on asthma‐related quality of life and some psychological outcomes, and lung function (relaxation only). Future trials should be informed by previous work to harmonize the interventions under study and outcome measures used to determine their effectiveness; only then will meaningful meta‐analyses inform clinical practice.
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Psychotherapy, such as cognitive-behavioural therapy and counselling, has had limited effectiveness in improving asthma outcomes.
“Despite this, psychotherapy, such as cognitive-behavioural therapy and counselling has had limited effectiveness in improving asthma outcomes.66”
From A systematic review of psychological, physical health factors, and quality of life in adult asthma (2019) · cites this paper as [66]
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A systematic review of psychological, physical health factors, and quality of life in adult asthma
Stanescu, S., Kirby, S. E., Thomas, M., Yardley, L., & Ainsworth, B. (2019) · npj Primary Care Respiratory Medicine · doi:10.1038/s41533-019-0149-3 · Cited by 124 · see citing works
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- Authors
- Yorke, J., Fleming, S., Shuldham, C., Rao, H., & Smith, H. E.
- Affiliations
- University of Manchester (GB)
- Royal Brompton & Harefield NHS Foundation Trust (GB)
- University of Brighton (GB)
- Corresponding author
- Yorke, J.
- ORCID
- Venue
- Clinical & Experimental Allergy
- Publisher
- Wiley
- Published
- 2015-11-19
- Volume
- 45
- Issue
- 12
- Pages
- 1750-1764
- ISSN
- 0954-7894 (ISSN-L)
- 1365-2222
- OpenAlex
- W2022687422
- Cited by
- 25
- References
- 48
- Citations by year
- 2024: 2 · 2023: 2 · 2022: 2 · 2021: 5 · 2020: 4 · 2019: 4 · 2018: 2 · 2017: 4
- FWCI
- 0.25
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Clinical & Experimental Allergy (publishedVersion)
- PubMed (publishedVersion)
- Research Explorer (The University of Manchester) (submittedVersion)
- Topics
- Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Chronic Obstructive Pulmonary Disease (COPD) Research
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Keywords
- asthma, non-pharmacological treatment, relaxation training, mindfulness, biofeedback, cognitive behavioral therapy, multicomponent intervention, asthma self-management, medication adherence, asthma quality of life, psychological outcomes, lung function, adults
- MeSH terms
- Adult, Asthma, Behavior Therapy, Humans, Health Behavior, Randomized Controlled Trials as Topic, Outcome Assessment, Health Care, Disease Management
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