Skip to content

Research at St Andrews

Interactive digital interventions to promote self-management in adults with asthma: systematic review and meta-analysis

Research output: Contribution to journalReview articlepeer-review


Gary McLean, Elizabeth Murray, Rebecca Band, Keith R. Moffat, Peter Hanlon, Anne Bruton, Mike Thomas, Lucy Yardley, Frances S. Mair

School/Research organisations


Background: To identify, summarise and synthesise the evidence for using interactive digital interventions to support patient self-management of asthma, and determine their impact.

Methods: Systematic review with meta-analysis. We searched MEDLINE, EMBASE, CINAHL, PsycINFO, ERIC, Cochrane Library, DoPHER, TROPHI, Social Science Citation Index and Science Citation Index. The selection criteria requirement was studies of adults (16 years and over) with asthma, interventions that were interactive digital interventions and the comparator was usual care. Outcomes were change in clinical outcomes, cost effectiveness and patient-reported measures of wellbeing or quality of life. Only Randomised Controlled Trials published in peer-reviewed journals in English were eligible.

Potential studies were screened and study characteristics and outcomes were extracted from eligible papers independently by two researchers. Where data allowed, meta-analysis was performed using a random effects model.
Results: Eight papers describing 5 trials with 593 participants were included, but only three studies were eligible for inclusion for meta-analysis. Of these, two aimed to improve asthma control and the third aimed to reduce the total dose of oral prednisolone without worsening control. Analyses with data from all three studies showed no significant differences and extremely high heterogeneity for both Asthma Quality of Life (AQLQ) (Standardised Mean Difference (SMD) 0.05; 95 % Confidence Interval (CI) 0.32 to -0.22: I2 96.8) and asthma control (SMD 0.21; 95 % CI -0.05 to .42; I2 = 87.4). The removal of the third study reduced heterogeneity and indicated significant improvement for both AQLQ (SMD 0.45; 95 % CI 0.13 to 0.77: I2 = 0.34) and asthma control (SMD 0.54; 95 % CI 0.22 to 0.86: I2 = 0.11). No evidence of harm was identified.

Conclusion: Digital self-management interventions for adults with asthma show promise, with some evidence of small beneficial effects on asthma control. Overall, the evidence base remains weak due to the lack of large, robust trials.


Original languageEnglish
Article number83
Number of pages14
JournalBMC Pulmonary Medicine
Publication statusPublished - 23 May 2016

    Research areas

  • Asthma, Usual care, Medication Adherence, Standardised Mean Difference

Discover related content
Find related publications, people, projects and more using interactive charts.

View graph of relations

Related by author

  1. What do we know about demand, use and outcomes in primary care out-of-hours services? A systematic scoping review of international literature

    Foster, H., Moffat, K. R., Burns, N., Gannon, M., Macdonald, S. & O'Donnell, C. A., 19 Jan 2020, In: BMJ Open. 10, 1, 17 p., e033481.

    Research output: Contribution to journalArticlepeer-review

  2. Factors associated with recruitment to randomised controlled trials in general practice: protocol for a systematic review

    Moffat, K. R., Cannon, P., Shi, W. & Sullivan, F., 10 May 2019, In: Trials. 20, 4 p., 66.

    Research output: Contribution to journalArticlepeer-review

  3. Management of multimorbidity using a patient-centred care model: a pragmatic cluster-randomised trial of the 3D approach

    Salisbury, C., Man, M-S., Bower, P., Guthrie, B., Chaplin, K., Gaunt, D. M., Brookes, S., Fitzpatrick, B., Gardner, C., Hollinghurst, S., Lee, V., McLeod, J., Mann, C., Moffat, K. R. & Mercer, S. W., 7 Jul 2018, In: Lancet. 392, 10141, p. 41-50

    Research output: Contribution to journalArticlepeer-review

  4. Safer Primary Care: Caring for People with Multiple Conditions: Safer Primary Care

    Mercer, S., Fischbacher-Smith, D., Furler, J., Sanci, L., Moffat, K. & D, D. S., 2016, World Health Organisation: World Health Organization.

    Research output: Book/ReportCommissioned report

  5. Challenges of managing people with multimorbidity in today's healthcare systems

    Moffat, K. & Mercer, S. W., 14 Oct 2015, In: BMC Family Practice. 16, 3 p., 129.

    Research output: Contribution to journalArticlepeer-review

Related by journal

  1. Toxicity related to standard TB therapy for pulmonary tuberculosis and treatment outcomes in the REMoxTB study according to HIV status

    Tweed, C. D., Crook, A. M., Dawson, R., Diacon, A. H., McHugh, T. D., Mendel, C. M., Meredith, S. K., Mohapi, L., Murphy, M. E., Nunn, A. J., Phillips, P. P. J., Singh, K. P., Spigelman, M. & Gillespie, S. H., 14 Aug 2019, In: BMC Pulmonary Medicine. 19, 9 p., 152.

    Research output: Contribution to journalArticlepeer-review

ID: 253267203