Band, R.

Bruton, A.

Hanlon, P.

Hiles, D.

Mair, F.

McLean, G.

Murray, E.

Saunderson, K.

Thomas, D.

Yardley, L.

Southampton (e-Prints Soton)

 PROSPERO International prospective register of systematic reviews Systematic review and meta-analysis of digital interventions for patient selfmanagement support for asthmaGary McLean, Frances Mair, Kathryn Saunderson, Rebecca Band, Anne Bruton, Elizabeth Murray, Mike Thomas, Lucy Yardley,David Hiles, Peter Hanlon  CitationGary McLean, Frances Mair, Kathryn Saunderson, Rebecca Band, Anne Bruton, Elizabeth Murray, Mike Thomas,Lucy Yardley, David Hiles, Peter Hanlon. Systematic review and meta-analysis of digital interventions for patient selfmanagement support for asthma. PROSPERO 2014:CRD42014013455 Available from  http://www.crd.york.ac.uk/PROSPERO_REBRANDING/display_record.asp?ID=CRD42014013455  Review question(s)To summarize current knowledge of the effectiveness of digital self-management support for adults with asthmaSearchesMEDLINE, EMBASE, CINAHL Plus, PsycINFO, ERIC, Cochrane Library (including CDSR, Cochrane CentralRegister of Controlled Trials (CENTRAL), DARE, NHS EED, and HTA databases), DoPHER and TROPHI (bothproduced by the EPPI Centre), Social Science Citation Index and Science Citation Index ExpandedTypes of study to be includedWe will consider only randomised controlled trials which have been published in peer reviewed journals where theintervention is aimed at those with a diagnosis of Asthma as defined by the authors. These trials must:(1) have randomised patients to an intervention and have a control group that is defined as usual care;(2) have quantitative data on changes in outcomes;(3) be of adults only (16+) or if including those below 16 years have data on those 16+ that can be extractedseparately;(4) defined as a digital intervention;(5) involve self- management by patients;(6) only studies published in English.Condition or domain being studiedAsthma is common, affecting an estimated 300 million people world-wide and the number of disability-adjusted lifeyears lost is estimated at 15million per year. The main goals of treatment for asthma include achieving andmaintaining control of symptoms, normal activity levels, minimal exacerbations, normal lung function and preventingdeaths from asthma. However, these goals are not widely achieved; people with asthma often tolerate unnecessarysymptoms, and management of the condition can often be suboptimal. Guided self-management for asthma as part ofsystematic, planned care can lead to improvements in patient outcomes such as increases in knowledge, confidence tomanage asthma and improved quality of life, as well as reductions in hospitalizations, emergency room visits,unscheduled visits to the doctor, and days off work.Participants/ populationAdults (aged 16 or over) with a diagnosis of asthma as defined by authors of primary studiesIntervention(s), exposure(s)We define “digital intervention” as any intervention delivered by digital technology. This includes, but is not limited                               Page: 1 / 4to, web-based interventions on PC or mobile devices, apps on smart phones, and interventions delivered by SMS orIVR (interactive voice recognition). Interventions should take information from users and provide tailored advice onself-management. Some form of facilitated or supported access may be included.Comparator(s)/ controlUsual care.We will also compare other groups in studies where there are additional controls in addition to usual care.Outcome(s)Primary outcomesPrimary outcomes may include:.• Measures of asthma control, Symptoms (e.g. diary card scores)• Measures of asthma quality of life• Exacerbations• Restricted activities (e.g. days of work/school/disturbed nights)• Lung function: e.g. spirometry & reversibility, peak expiratory f low• Medication utilisation • Compliance with medication• Health service utilisation (including scheduled/unscheduled, and primary/secondarycare)• Biomarkers of airway inflammation (e.g. exhaled nitric oxide)• Adverse eventsSecondary outcomes• Patient satisfaction• Patient knowledge• Adherence to monitoring tools• Recruitment and retention rates• Markers of self care (action plan use, inhaler technique for example)• Data about economic benefits.Data extraction, (selection and coding)Studies that meet the inclusion criteria will then be screened in full by a minimum of two reviewers workingindependently to extract the relevant population, intervention and outcome data as relates to the primary andsecondary outcomes above. This will be completed using data extraction forms on the Distiller software(http://systematic-review.net/) based on established data extraction forms. Again any inter-reviewer disagreementswill be resolved by seeking consensus or decision by a third partyRisk of bias (quality) assessmentRisk of bias will be assessed in each of the included studies by the reviewers working independently. They will assess                               Page: 2 / 4data bias as per the Cochrane collaboration’s tool for assessing bias. Areas of bias that will be assessed will include;allocation concealment, method of generation of allocation sequence, how knowledge of the allocated interventionwas prevented during the study, whether incomplete outcome data was assessed, whether there was evidence ofselective outcome reporting and whether there were any other problems that put the study at high risk of bias.Strategy for data synthesisData will be synthesised using Distiller software. Tests for heterogeneity and publication bias will be conducted. Meta-regression will be performed to evaluate whether baseline factors may influence the significance and strength of theeffect size.Analysis of subgroups or subsetsThis will depend on the results found. The meta-analysis could be stratified by type of intervention; time period ofintervention; and/or study population.Dissemination plansIt is intended to publish proctocol and final results of review and analysis in peer review journals.Contact details for further informationDr McLeanUniversity of GlasgowGeneral Practice & Primary Care 1 Horslethill Road Glasgow G12 9LXgary.mclean@glasgow.ac.ukOrganisational affiliation of the reviewUniversity of Glasgow/University of SouthamptonReview teamDr Gary McLean, University of GlasgowProfessor Frances Mair, University of GlasgowDr Kathryn Saunderson, University of GlasgowDr Rebecca Band, University of SouthamptonDr Anne Bruton, University of SouthamptonProfessor Elizabeth Murray, University College LondonProfessor Mike Thomas, University of SouthamptonProfessor Lucy Yardley, University of SouthamptonDr David Hiles, Asthma UkDr Peter Hanlon, University of GlasgowAnticipated or actual start date18 August 2014Anticipated completion date01 July 2015Funding sources/sponsorsNational Institute for Health ResearchConflicts of interest                               Page: 3 / 4None knownLanguageEnglishCountryEngland, ScotlandSubject index terms statusSubject indexing assigned by CRDSubject index termsAsthma; Humans; Self CareStage of reviewOngoingDate of registration in PROSPERO27 August 2014Date of publication of this revision27 August 2014DOI10.15124/CRD42014013455Stage of review at time of this submission Started CompletedPreliminary searches Yes   No Piloting of the study selection process   No   No Formal screening of search results against eligibility criteria   No   No Data extraction   No   No Risk of bias (quality) assessment   No   No Data analysis   No   No  PROSPEROInternational prospective register of systematic reviewsThe information in this record has been provided by the named contact for this review. CRD has accepted this information in goodfaith and registered the review in PROSPERO. CRD bears no responsibility or liability for the content of this registration record,any associated files or external websites. Powered by TCPDF (www.tcpdf.org)                               Page: 4 / 4

Systematic review and meta-analysis of digital interventions for patient self-management support for asthma

Systematic review and meta-analysis of digital interventions for patient self-management support for asthma

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