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Barriers and facilitators of effective self-management in asthma: systematic review and thematic synthesis of patient and healthcare professional views

Barriers and facilitators of effective self-management in asthma: systematic review and thematic synthesis of patient and healthcare professional views
Barriers and facilitators of effective self-management in asthma: systematic review and thematic synthesis of patient and healthcare professional views
Self-management is an established, effective approach to controlling asthma, recommended in guidelines. However, promotion, uptake and use among patients and health-care professionals remain low. Many barriers and facilitators to effective self-management have been reported, and views and beliefs of patients and health care professionals have been explored in qualitative studies. We conducted a systematic review and thematic synthesis of qualitative research into self-management in patients, carers and health care professionals regarding self-management of asthma, to identify perceived barriers and facilitators associated with reduced effectiveness of asthma self-management interventions. Electronic databases and guidelines were searched systematically for qualitative literature that explored factors relevant to facilitators and barriers to uptake, adherence, or outcomes of self-management in patients with asthma. Thematic synthesis of the 56 included studies identified 11 themes: (1) partnership between patient and health care professional; (2) issues around medication; (3) education about asthma and its management; (4) health beliefs; (5) self-management interventions; (6) co-morbidities (7) mood disorders and anxiety; (8) social support; (9) non-pharmacological methods; (10) access to healthcare; (11) professional factors. From this, perceived barriers and facilitators were identified at the level of individuals with asthma (and carers), and health-care professionals. Future work addressing the concerns and beliefs of adults, adolescents and children (and carers) with asthma, effective communication and partnership, tailored support and education (including for ethnic minorities and at risk groups), and telehealthcare may improve how self-management is recommended by professionals and used by patients. Ultimately, this may achieve better outcomes for people with asthma.
2055-1010
Miles, Clare
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Arden-Close, Emily
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Thomas, Mike
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Bruton, Anne
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Yardley, Lucy
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Hankins, Matthew
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Kirby, Sarah
9be57c1b-5ab7-4444-829e-d8e5dbe2370b
Miles, Clare
e9baac68-90b1-4d6d-98de-bba1cd8377c3
Arden-Close, Emily
0e18e0ef-cde3-447e-a593-e3bce3920226
Thomas, Mike
997c78e0-3849-4ce8-b1bc-86ebbdee3953
Bruton, Anne
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Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Hankins, Matthew
ce4b7d68-3320-4af4-9dd7-3537a4b07219
Kirby, Sarah
9be57c1b-5ab7-4444-829e-d8e5dbe2370b

Miles, Clare, Arden-Close, Emily, Thomas, Mike, Bruton, Anne, Yardley, Lucy, Hankins, Matthew and Kirby, Sarah (2017) Barriers and facilitators of effective self-management in asthma: systematic review and thematic synthesis of patient and healthcare professional views. NPJ primary care respiratory medicine, 27. (doi:10.1038/s41533-017-0056-4).

Record type: Article

Abstract

Self-management is an established, effective approach to controlling asthma, recommended in guidelines. However, promotion, uptake and use among patients and health-care professionals remain low. Many barriers and facilitators to effective self-management have been reported, and views and beliefs of patients and health care professionals have been explored in qualitative studies. We conducted a systematic review and thematic synthesis of qualitative research into self-management in patients, carers and health care professionals regarding self-management of asthma, to identify perceived barriers and facilitators associated with reduced effectiveness of asthma self-management interventions. Electronic databases and guidelines were searched systematically for qualitative literature that explored factors relevant to facilitators and barriers to uptake, adherence, or outcomes of self-management in patients with asthma. Thematic synthesis of the 56 included studies identified 11 themes: (1) partnership between patient and health care professional; (2) issues around medication; (3) education about asthma and its management; (4) health beliefs; (5) self-management interventions; (6) co-morbidities (7) mood disorders and anxiety; (8) social support; (9) non-pharmacological methods; (10) access to healthcare; (11) professional factors. From this, perceived barriers and facilitators were identified at the level of individuals with asthma (and carers), and health-care professionals. Future work addressing the concerns and beliefs of adults, adolescents and children (and carers) with asthma, effective communication and partnership, tailored support and education (including for ethnic minorities and at risk groups), and telehealthcare may improve how self-management is recommended by professionals and used by patients. Ultimately, this may achieve better outcomes for people with asthma.

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Barriers and facilitators of effective self-management in asthma - Accepted Manuscript
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Accepted/In Press date: 7 September 2017
e-pub ahead of print date: 9 October 2017

Identifiers

Local EPrints ID: 414737
URI: https://eprints.soton.ac.uk/id/eprint/414737
ISSN: 2055-1010
PURE UUID: 7327a402-6fe4-4c40-8ade-6d02db7a0272
ORCID for Anne Bruton: ORCID iD orcid.org/0000-0002-4550-2536
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X
ORCID for Sarah Kirby: ORCID iD orcid.org/0000-0003-1759-1356

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Date deposited: 09 Oct 2017 16:30
Last modified: 10 Sep 2019 04:41

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Contributors

Author: Clare Miles
Author: Emily Arden-Close
Author: Mike Thomas
Author: Anne Bruton ORCID iD
Author: Lucy Yardley ORCID iD
Author: Matthew Hankins
Author: Sarah Kirby ORCID iD

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