Hani Salim|Siti Nurkamilla Ramdzan|Sazlina Shariff Ghazali|Ping Yein Lee|Ingrid Young|Kirstie McClatchey|Hilary Pinnock
A systematic review of interventions addressing limited health literacy to improve asthma self-management
University of Edinburgh|University of Malaya|University of Edinburgh|Universiti Putra Malaysia|Universiti Putra Malaysia|Universiti Putra Malaysia|University of Edinburgh|Institute of Occupational Medicine|Asthma UK|University of Edinburgh|University of Edinburgh
systematic review interventions addressing limited health literacy improve asthma selfmanagement background supported asthma selfmanagement improves health outcomeshowever people limited health literacy especially lowermiddleincome countries lmics may need tailored interventions enable realise benefitswe aimed assess clinical effectiveness asthma selfmanagement interventions targeted people limited health literacy identify strategies associated effective programmesmethods following cochrane methodology searched ten databases january 1990 june 2018 updated october 2019 without language restrictionwe included controlled experimental studies whose interventions targeted health literacy improve asthma selfmanagementselection papers extraction data quality assessment done independently two reviewersthe primary outcomes clinical asthma control implementation adoptionadherence interventionanalysis narrative resultswe screened 4318 titles abstracts reviewed 52 fulltexts included five trialsone trial conducted lmicrisk bias low one trial high four studiesclinical outcomes reported two trials high risk bias one reported reduction unscheduled care number visits 6month sd intervention0912 vs control1824 p 0001 showed effectnone reported uptake adherence interventionbehavioural change strategies typically focused improving individual psychological physical capacity enact behaviour eg targeting asthmarelated knowledge comprehensiononly two interventions also targeted motivation none sought improve opportunityless half interventions used specific selfmanagement strategies eg written asthma action plan tailoring limited health literacy statusdifferent approaches eg videobased pictorial action plans used provide education conclusionsthe paucity studies diversity interventions support people limited health literacy selfmanage asthma meant impact health outcomes remains uncleargiven proportion global population limited health literacy skills research priority