UCL Great Ormond Street Institute of Child Health, University College London, London, United Kingdom.
Whittington Health NHS Trust, London, United Kingdom.
J Asthma. 2021 Jan;58(1):112-120. doi: 10.1080/02770903.2019.1658209. Epub 2019 Sep 18.
Asthma outcomes are significantly worse for minority groups, including South Asians (SAs), in high-income settings. Despite this, comparatively few existing studies have focused on SAs when studying the effectiveness of behavioral interventions on asthma self-management, and no prior study has synthesized these findings. We review the effectiveness of behavioral interventions on asthma management in adults and children of SA origin across low- (LICs), middle- (MICs), and high-income countries (HICs).
Data sources included EMBASE, MEDLINE, Cochrane Library and Trial registries: WHO, ICTRP and ClinicalTrials.gov. Eligibility criteria: randomized controlled trials (RCTs), quasi-RCTs and non-RCTs (controlled before-after [CBA] studies), published in English, with no publication year or country restrictions in adults and children of South Asian origin. Exclusion criteria: those focusing solely on pharmacological interventions. Search terms were "asthma" and "South Asian".
We included 33 studies, 27 from MICs and 6 from HICs (education [ = 10], self-management plans [ = 6], yoga/breathing exercises [ = 10]) organizational interventions [ =1], diet therapy [ = 1] and combined interventions [ = 5]). Outcome measures included: blood biochemistry, lung function, healthcare utilization and quality of life. A meta-analysis was not performed due to significant study heterogeneity.
Behavioral interventions for asthma management in SAs are effective. Educational interventions that aim to optimize asthma knowledge, control, and inhaler technique, and yoga/breathing exercises are most effective for improved long-term outcomes in adults and children across LICs and MICs. Further research is needed to evaluate the effectiveness of all behavioral interventions for SAs in HICs to better inform current guidance by policy makers and health care providers.
在高收入环境中，少数群体（包括南亚人）的哮喘结局明显较差。尽管如此，在研究行为干预对哮喘自我管理的有效性时，很少有现有研究关注南亚人，也没有先前的研究综合这些发现。我们综述了在低收入（LICs）、中收入（MICs）和高收入国家（HICs）中，针对南亚裔成年人和儿童的哮喘管理的行为干预的有效性。
数据来源包括 EMBASE、MEDLINE、Cochrane 图书馆和试验登记处：世界卫生组织、国际临床试验注册平台和临床试验.gov。纳入标准：随机对照试验（RCTs）、准 RCTs 和非 RCTs（对照前后研究），以英文发表，对南亚裔成年人和儿童无发表年份或国家限制。排除标准：仅关注药物干预的研究。搜索词为“哮喘”和“南亚”。
我们纳入了 33 项研究，其中 27 项来自 MICs，6 项来自 HICs（教育[=10]、自我管理计划[=6]、瑜伽/呼吸练习[=10]、组织干预[=1]、饮食疗法[=1]和联合干预[=5]）。结局指标包括：血液生化、肺功能、医疗保健利用和生活质量。由于研究异质性显著，未进行荟萃分析。
针对南亚人哮喘管理的行为干预是有效的。旨在优化哮喘知识、控制和吸入器技术的教育干预以及瑜伽/呼吸练习，对改善成年人和儿童在 LICs 和 MICs 的长期结局最有效。需要进一步研究来评估所有针对 HICs 的南亚人行为干预的有效性，以便为政策制定者和医疗保健提供者提供更好的指导。
