Table 2.
Cochrane EPOC taxonomy implementation strategies coded for asthma supported self-management educational initiatives
| Study, country, risk of bias | Cabana 2006a USA Unclear |
Clark 1998a USA Unclear |
Griffiths 2016a UK Unclear |
Shah 2011a Australia Unclear |
Cohen 2014 Israel High |
Evans 1997 USA Unclear |
Sheikh 2016 USA Unclear |
Bruzzese 20061 USA Unclear |
Cleland 2007 UK Unclear |
Homer 2005 USA High |
Prabhakaran 2012 Singapore Unclear |
Smeele 1999 Netherlands Unclear |
Toelle 1993 Australia High |
Tomson 1997 Sweden High |
Volovitz 2003 Israel High |
|||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| I1 | I2 | I3 | I4 | I1 | I2 | I3 | I1 | I2 | ||||||||||||||
| Evidence of effectiveness? | Y | Y | Y | Y | Y | Y | Y | Y | Y | Y | N | N | N | N | N | N | N | N | N | N | N | |
| Implementation outcomes | NR | Action plan | NR | Action plan | NR | Action plan; Patient education |
Action plan; Patient education | NR | NR | Action plan | Knowledge | Patient education | NR | Action plan | NR | |||||||
| Health outcomes | Urgent office visit; ED visit; Hospital-isation |
ED visit; Hospital-isation | Unscheduled care; Time to first unscheduled care; QoL |
Hospital-isation | Asthma control | Control medication | Acute care visit | Urgent physician visit; ED visit; Hospital-isation |
Steroid courses; QoL; Asthma control |
ED visit; Hospital-isation; Asthma attacks | NR | Exacerbation | Unscheduled doctor/ ED visit; Symptoms limiting activity | Control medication | Shortness of breath | |||||||
| Audit & feedback | ✓ | 1 | ||||||||||||||||||||
| Monitoring the performance of the delivery of healthcare | ✓ | ✓ | ✓ | 3 | ||||||||||||||||||
| Communities of practice | ✓ | ✓ | 2 | |||||||||||||||||||
| Continuous quality improvement | ✓ | 1 | ||||||||||||||||||||
| Educational meetings | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 19 | ||
| Educational materials | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 21 |
| Educational outreach visits/academic detailing | ✓ | ✓ | ✓ | ✓ | ✓ | 5 | ||||||||||||||||
| Clinical practice guidelines | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 16 | |||||
| Inter-professional education | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 6 | |||||||||||||||
| Local consensus processes | ✓ | ✓ | 2 | |||||||||||||||||||
| Local opinion leaders | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 7 | ||||||||||||||
| Educational games | ✓ | ✓ | ✓ | ✓ | 4 | |||||||||||||||||
| Otherb | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | ✓ | 8 | |||||||||||||
| Total | 4 | 4 | 5 | 3 | 3 | 5 | 7 | 8 | 7 | 6 | 5 | 4 | 8 | 2 | 2 | 2 | 5 | 4 | 4 | 4 | 3 | 95 |
BOLD are significant results in favour of the intervention
Strategies not coded: Clinical incident reporting; Managerial supervision; Public release of performance data; Routine patient-reported outcome measures; Patient-mediated interventions; Tailored interventions; Reminders
EPOC: Effective Practice and Organisation of Care. I, intervention; N, no; NR, not reported; QoL, quality of life; Y, yes
aStudy evaluated the Physician Asthma Care Education (PACE) programme
bBruzzese: School health team training. Griffiths: patients received invitation to attend Chronic Disease Self Management Programme (CDSMP). Cohen: Training in the proper use of different kinds of inhalers. Sheikh: elements aimed at patients. Toelle: elements aimed at patients, parents, school teachers. Tomson: Generation of relevant topics for the information by direct contact with GPs before designing the information package. Volovitz: elements aimed at patients.