Centre for Medicine Use and Safety, Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia.
National Health and Medical Research Council, Centre for Research Excellence in Severe Asthma and Centre of Excellence in Treatable Traits, the University of Newcastle, Newcastle, Australia; The Priority Research Centre for Healthy Lungs, School of Nursing and Midwifery, Newcastle, Australia; Department of Respiratory and Sleep Medicine, John Hunter Hospital, Hunter Medical Research Institute, Newcastle, Australia.
J Allergy Clin Immunol Pract. 2022 Sep;10(9):2333-2345.e21. doi: 10.1016/j.jaip.2022.05.012. Epub 2022 May 26.
The management of obstructive airway diseases (OADs) is complex. The treatable traits (TTs) approach may be an effective strategy for managing OADs.
To determine the effectiveness of interventions targeting TTs for managing OADs.
Ovid Embase, Medline, CENTRAL, and CINAHL Plus were searched from inception to March 9, 2022. Studies of interventions targeting at least 1 TT from pulmonary, extrapulmonary, and behavioral/lifestyle domains were included. Two reviewers independently extracted relevant data and performed risk-of-bias assessments. Meta-analyses were performed using random-effects models. Subgroup and sensitivity analyses were carried out to explore heterogeneity and to determine the effects of outlying studies.
Eleven studies that used the TTs approach for OAD management were identified. Traits targeted within each study ranged from 13 to 36. Seven controlled trials were included in meta-analyses. TT interventions were effective at improving health-related quality of life (mean difference [MD] = -6.96, 95% CI: -9.92 to -4.01), hospitalizations (odds ratio [OR] = 0.52, 95% CI: 0.39 to 0.69), all-cause-1-year mortality (OR = 0.65, 95% CI: 0.45 to 0.95), dyspnea score (MD = -0.29, 95% CI: -0.46 to -0.12), anxiety (MD = -1.61, 95% CI: -2.92 to -0.30), and depression (MD = -2.00, 95% CI: -3.53 to -0.47).
Characterizing TTs and targeted interventions can improve outcomes in OADs, which offer a promising model of care for OADs.
阻塞性气道疾病（OAD）的管理较为复杂。可治疗特征（TTs）方法可能是管理 OAD 的有效策略。
确定针对 TTs 管理 OAD 的干预措施的有效性。
从建库至 2022 年 3 月 9 日，检索了 Ovid Embase、Medline、CENTRAL 和 CINAHL Plus。纳入了针对肺部、肺外和行为/生活方式领域至少 1 个 TTs 的干预措施研究。两位审查员独立提取相关数据并进行偏倚风险评估。采用随机效应模型进行荟萃分析。进行了亚组和敏感性分析，以探索异质性并确定异常研究的影响。
确定了 11 项使用 TTs 方法管理 OAD 的研究。每项研究中针对的特征范围从 13 到 36。纳入了 7 项对照试验进行荟萃分析。TT 干预措施可有效改善健康相关生活质量（平均差值 [MD] = -6.96，95%CI：-9.92 至 -4.01）、住院治疗（比值比 [OR] = 0.52，95%CI：0.39 至 0.69）、1 年全因死亡率（OR = 0.65，95%CI：0.45 至 0.95）、呼吸困难评分（MD = -0.29，95%CI：-0.46 至 -0.12）、焦虑（MD = -1.61，95%CI：-2.92 至 -0.30）和抑郁（MD = -2.00，95%CI：-3.53 至 -0.47）。
对 TTs 和靶向干预措施进行特征描述可改善 OAD 的结局，为 OAD 提供了一种有前途的护理模式。
