Psychotherapeutic interventions for adults with asthma

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 until September 2003. 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. 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 Twelve studies were included in the review, however study quality was poor and sample sizes were frequently small. No meta-analysis could be performed due to the diversity of interventions and the outcomes assessed. 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. Large, 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.

Professional and patient attitudes to using mobile phone technology to monitor asthma: questionnaire survey

“…The questionnaire asked about attitudes to such innovative technology, focusing on its acceptability, practicability and impact on care (see associated with this article, located, in the online version, at Supplementary data doi: 10.1016/j.pcrj.2006.03.001). Designed by a multidisciplinary team, our questions were based on a detailed review of the literature on the use of mobile technology to monitor chronic disease [1][2][3], the process of adoption of new technologies [20], and the concepts of asthma self-management [15][16][17]. Minor adjustments were made after initial piloting.…”

“…Guided by written asthma action plans, some patients accept the responsibility for monitoring and adjusting their own treatment [11], whilst others fail to respond to cues for self-management [12,13] and delay important actions pending the advice of a clinician [14][15][16][17]. Novel technologies may change the dynamics of monitoring and care.…”

Moving towards effective chronic illness management: asthma as an exemplar

“…Psychotherapeutic interventions presented in the review studies included cognitive behavioral therapy, cognitive therapy, behavioral therapy, relaxation therapy, supportive counseling, hypnosis, individual and group therapy formats, and patient education programs with a psychotherapy emphasis. Fleming et al 50 found insufficient evidence to draw any definitive conclusions regarding the effectiveness of psychological interventions in asthma. The authors also reported that the inadequate number of studies (n ¼ 12) and the investigations' poor quality of study design, small sample sizes, diversity of interventions, and conflicting findings limited their systematic review.…”

“…The inadequate number of available studies for Fleming et al 50 to review reflects the lack of literature that goes beyond the mere study of educational interventions to help patients self-manage their asthma. Although numerous studies have examined asthma self-management, the majority of research has focused only on education, medication, adherence to medical regimens, and barriers.…”

Psychological treatments in liaison psychiatry: the evidence base

“…Table 1 [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] summarises the main highquality systematic reviews of psychological treatment interventions in liaison psychiatry. This updates the work of Ruddy and House 17 who reviewed both pharmacological and psychological systematic reviews of treatment interventions in liaison psychiatry from 1980 to the end of 2002.…”