Effectiveness of family-focused interventions on symptom control and prevention of exacerbations among pediatric bronchial asthma Patients: A systematic review and meta-analysis

ABSTRACT

@#<p style="text-align justify;"><strong>BACKGROUND:</strong> Bronchial asthma is regarded as one of the most common diseases burdening young children worldwide. Family-focused interventions show promising results in achieving asthma control.<br /></p><p style="text-align justify;"><strong>OBJECTIVE:</strong> This meta-analysis was conducted to determine the effectiveness of family-focused interventions among patients with bronchial asthma on 1) prevention of ED visit, 2) improvement of quality of life, 3) improvement of lung function, 4) limitation of activities and 5) family-related outcomes.<br /></p><p style="text-align justify;"><strong>METHODS:</strong> This is a meta analysis of randomized controlled studies on the effectiveness of family interventions in the control of asthma of pediatric patients. Eligible studies for the meta-analysis were searched on electronic databases of Pubmed, Cochrane, Grey Literature and by cross referencing. These studies were reviewed by two investigators. These studies were then grouped into educational and psychological interventions. Similar outcomes such as asthma control, lung function and QOL were compared between groups.<br /></p><p style="text-align justify;"><strong>RESULTS:</strong> There were no statistically significant differences between intervention and control groups in the studies that used educational intervention (RR 0.93 [0.64, 1.93], I² = 0) and studies that used psychosocial intervention (RR= 0.99 [0.98,1.01], I²=0) with regards to ED visits. Limitation of activity improved after initiation of psychosocial therapy (SMD score of -0.71 [-1.02, -0.40], I² = 0). Lung Function improved after psychosocial interventions (SMD 0.49 [0.27, 0.71], I²=3%). There was no observed difference in participant QOL between the two groups. Family knowledge and attitude did not significantly improve after intervention however caregiver QOL scores and Family Environment Scale showed statistically significant changes after intervention was performed.<br /></p><p style="text-align justify;"><strong>CONCLUSION:</strong> Family-based therapies, specifically psychosocial interventions, improve lung function, limitation of activity and caregiver QOL. Family-physicians need to strengthen these strategies to better help asthma patients.</p>