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Table 1 Characteristics of included papers

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

Author (Year) Definition of Asthma Population Numbers (I = Intervention, C = Control) Mean Ethnicity (I = Intervention, C = Control N (%) Outcomes assessed Main results
Age (years) Males
Location (I = Intervention, C = Control (I = Intervention, C = Control
van Gaalen [30] (2013)
Netherlands
physician-diagnosed prescription of inhaled corticosteroids ≥3 months in the previous year I =47, C = 60 I = 37.0
C = 36.
N/A I = 12 (26), C = 19 (32) AQLQ, ACQ, Symptom-free days, FEV, daily inhaled corticosteroids(DCID At 30 months after baseline, a sustained and significant difference in terms of asthma-related quality of life of 0.29 (95 % CI 0.01-0.57) and asthma control of −0.33 (95 % CI −0.61 to −0.05) was found in favor of the Intervention group. No sig differences were found for FEV2 or daily inhaled corticosteroids
Van der Meer [31] (2009)
Netherlands
Physician-diagnosed prescription of inhaled corticosteroids ≥3 months in the previous year I = 99
C = 101
I = 37.0
C = 36.0
N/A I = 29(29)
C = 32 (32)
Asthma knowledge, Inhaler technique, Self-reported medication adherence, Physician visits, Telephone contacts, medication changes, AQLQ, ACQ, Symptom-free days, FEV, DCID Asthma-related quality of life showed a greater increase in the intervention group(adjusted between-group difference, 0.38 [95 % CI, 0.20 to 0.56]). . Asthma control improved more in the I group than in the UC group (adjusted difference, _0.47 [CI, _0.64 to _0.30]).
Van der Meer [32] (2010)
Netherlands
physician-diagnosed prescription of inhaled corticosteroids ≥3 months in the previous year I = 99
C = 101
(subgroups ) well controlled asthma (I = 37, C = 38), partly controlled asthma (I = 38, C = 33), Uncontrolled asthma (I = 26, C = 28)
well controlled asthma (I = 35.8, C = 36.7), partly controlled asthma (I = 35.5, C = 36.3), Uncontrolled asthma (I = 36.9, C = 36.0) N/a well controlled asthma (I = 11(29.7 %), C = 12(31.6 %)), partly controlled asthma (I = 8 (21.1 %)
C = 10 (30.3)), Uncontrolled asthma I = 13(50.0 %)
C = 7 (25.0)
Self-reported medication adherence, , medication changes,ACQ, daily inhaled corticosteroids(DCID) Improvements in ACQ score after 12 months were −0.14 (p = 0.23), −0.52 (p < 0.001) and −0.82 (p < 0.001) in the intervention group compared to usual care for patients with well, partly and uncontrolled asthma at baseline, respectively. Daily inhaled corticosteroid dose significantly increased in the Internet group compared to usual care in the first 3 months in patients with uncontrolled asthma (+278 μg, p = 0.001
Van der Meer [33] (2011)
Netherlands
physician-diagnosed prescription of inhaled corticosteroids ≥3 months in the previous year I = 99
C = 101
I = 37.0
C = 36.0
N/A I = 29(29)
C = 32 (32)
quality adjusted life years (QALYs), costs for health care use and absenteeism QALYs did not statistically significantly differ between the Intervention group and usual care. Costs of the Internet-based intervention were $254 (95 % CI, $243 to $265) during the period of 1 year. From a societal perspective, the cost difference was $641 (95 % CI, $21957 to $3240). From a health care perspective, the cost difference was $37 (95 % CI, $2874 to $950).
Hashimoto [34] (2011)
Netherlands
diagnosis of severe refractory asthma according to the major and minor criteria recommended by the American Thoracic Society I = 51
C = 38
I = 48.5
C = 52.4
n/a I = 23 (45)
C = 18 (47)
AQLQ, ACC, Slope FEV1, Exacerbations, Days of hospitalisation per patient, ICS, Sparing of oral corticosteroids,
prednisone dose
Median cumulative sparing of prednisone was 205 (25-75th percentile 221 to 777) mg in the internet strategy group compared with 0 (497 to
282) mg in the conventional treatment group (p = 0.02).
Bender [35] (2012)
USA
Physician diagnosed
asthma for which they were prescribed
daily inhaled corticosteroid treatment
I = 25, C = 25 I = 39.6
C = 43.5
I = 56 % white, 24 % Hispanic, 20 % African American, 0 % Asian.
C = 60 % white, 12 % Hispanic, 20 % African American, 0 % Asian.
I = 10 (40 %)
C = 8(32 %)
Medication Adherence, Belief in Medications Questionnaire, AQLQ, ACT No differences emerged for the AQLQ or ACT. Adherence was 32 % higher in intervention group and increased score in belief in medication was found for intervention group
Liu [36] (2011)
Taiwan
moderate-to-severe persistent asthma based on criteria for asthma as defined by the American Thoracic Society on the basis of clinical symptoms and physical examination. I = 43
C = 46
I = 50.4
C = 54
n/a I = 22(51 %),
C = 22(47.8 %)
PEFR L-min-, FEV1 % pred, SF-121 physical component score, SF-121 mental component scoreCS, inhaled corticosteroids dosage, Systemic steroid dosage, Antileukotriene, exacerbations, unscheduled visits to hospital In the intervention, mean SEM peak expiratory flow rate significantly increased at 4) and 6 months (compared to the control group. The intervention group also had better quality of life after 3 months, as determined using the Short Form-121 physical component score, and fewer episodes of exacerbation and unscheduled visits than the control group.
Rasumussen [37] (2013)
Denmark
diagnosed on the basis of a combination of respiratory symptoms and at least one objective measurement of asthma (i.e., airway hyper responsiveness to inhaled methacholine of <4 mmol, peak expiratory flow [PEF] variability of >20 %, and/or a minimum of 15 % [300 mL] increase in FEV1 after bronchodilation) I = 80
C = 85
I = 28
C = 30
N/A I = 27(33.9 %)
C = 30 (35.3.7 %)
Symptoms, AQLQ, FEV1 _300 mL, airway hyper responsiveness. Improvement was found for the intervention group versus control for asthma symptoms Internet vs GP: odds ratio of 3.26; P < .001, AQLQ (odds ratio of 2.10, P = .04) lung function (odds ratio of 4.86, P < .001), airway hyper responsiveness. (odds ratio of 3.06, P = .02)
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