Asthma self-management, which includes patient education, an action plan and regular review, seems to reduce hospitalisations, A&E attendances and unscheduled consultations, according to BMC Medicine.
The authors examined 27 previous systematic reviews, covering 244 randomised controlled trials (RCTs). They also included 13 RCTs published since the last search dates of the previous reviews. Based on four meta-analyses, the proportion of patients hospitalised declined from 7.2-25.9 per cent (depending on the study) to 4.6-14.0 per cent.
A&E attendances declined from 19.4-30.7 per cent to 13.1-22.4 per cent. The proportion of patients having unscheduled consultations declined from 36.6 to 24.9 per cent in one meta-analysis and from 22.0 to 14.3 per cent in the other. Reduced hospitalisations and A&E visits offset the cost of self-management support.
Self-management also seems to improve asthma control and quality of life. For example, six out of 10 reviews reported that self-management reduced symptoms.
The other four reviews examining symptom control reported inconsistent results or no benefit.
BMC Medicine DOI: 10.1186/s12916-017-0823-7