Muneswarao Jaya, Hassali Mohamed Azmi, Ibrahim Baharudin, Saini Bandana, Hyder Ali Irfhan Ali, Rehman Anees Ur, Verma Ashutosh Kumar, Naqvi Atta Abbas, Hussain Rabia
School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.
School of Pharmaceutical Sciences, Universiti Sains Malaysia, Penang, Malaysia.
J Allergy Clin Immunol Pract. 2020 Oct;8(9):3036-3055. doi: 10.1016/j.jaip.2020.05.032. Epub 2020 Jun 2.
The effectiveness of home visits is well discussed for children with asthma, but limited in adults.
The present systematic review aimed to investigate the potential role of home visits in improving outcomes among adult patients with asthma.
The systematic review was performed in line with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. An extensive literature search was conducted using databases such as PubMed, ProQuest, CINAHL, The Cochrane Library, PsycINFO, and Google Scholar from inception to June 2019. The studies included were randomized controlled trials, which reported asthma outcomes in adult patients.
The literature search yielded 8331 publications, of which 63 studies were selected for full-text review, and of these studies, 9 studies with a total of 2011 patients were included in the final analysis. The included randomized controlled trials reported quality of life, asthma symptoms, exacerbations, health care utilization, and pulmonary function. Improvements in asthma outcomes were observed predominantly in quality of life. The effects on asthma symptom control were inconsistent. The evidence on the impact of home visits in asthma exacerbations and health care utilization was rather limited. There were no significant differences observed between intervention versus control arms in terms of pulmonary function; however, 1 study reported significant improvements in peak expiratory flow rate.
Home visits may serve as an adjuvant activity that complements the existing health care system-based initiatives. It may be concluded that home visits have the potential to improve outcomes in adult patients with asthma; however, the randomized controlled trials reviewed in the present systematic review reported several limitations that warrant further investigation.
家访对哮喘儿童的有效性已得到充分讨论，但在成人中却很有限。
本系统评价旨在探讨家访在改善成年哮喘患者预后方面的潜在作用。
本系统评价按照系统评价和Meta分析的首选报告项目声明进行。从创刊至2019年6月，使用PubMed、ProQuest、CINAHL、Cochrane图书馆、PsycINFO和谷歌学术等数据库进行了广泛的文献检索。纳入的研究为随机对照试验，报告了成年患者的哮喘结局。
文献检索共获得8331篇出版物，其中63项研究被选进行全文审查，最终分析纳入了其中9项研究，共2011例患者。纳入的随机对照试验报告了生活质量、哮喘症状、急性加重、医疗保健利用和肺功能。哮喘结局的改善主要体现在生活质量方面。对哮喘症状控制的影响不一致。关于家访对哮喘急性加重和医疗保健利用影响的证据相当有限。干预组和对照组在肺功能方面未观察到显著差异；然而，1项研究报告呼气峰值流速有显著改善。
家访可作为一种辅助活动，补充现有的基于医疗保健系统的举措。可以得出结论，家访有可能改善成年哮喘患者的结局；然而，本系统评价中纳入的随机对照试验报告了一些局限性，值得进一步研究。
