Summary of findings 2. Multimedia training compared with control versus usual care for people with asthma.

Multimedia training compared with control/usual care for people with asthma
Patient or population: adults and children with asthma Setting: primary and secondary care Intervention: multi‐media training Comparison: control/usual care
Outcomes		Anticipated absolute effects* (95% CI)		Relative effect (95% CI)	Number of participants (studies)	Quality of the evidence (GRADE)	Comments
		Risk with control/usual care	Risk with multi‐media training
Correct inhaler technique Immediately after intervention	Adults	30 per 100	47 per 100 (26 to 70)	OR 2.15 (0.84 to 5.50)	164 (2 RCTs)	⊕⊕⊕⊝ MODERATEa,b
Correct inhaler technique 2‐Week follow‐up	Adults	43 per 100	57 per 100 (23 to 86)	OR 1.78 (0.40 to 7.94)	28 (1 RCT)	⊕⊕⊝⊝ LOWa,c
Inhaler technique score	Adults	Not pooled; narrative summary of evidence provided in data table (Analysis 3.3)		‐	136 (2 RCTs)	Not graded	Suggests benefit of multi‐media training over control
	Children	Not pooled; narrative summary of evidence provided in data table (Analysis 4.1)		‐	127 (2 RCTs)	Not graded	Suggests benefit of multi‐media training over control
Asthma control (ACT) 4 weeks	Children	Mean change in control group was 1.2	Mean change was 0.73 better (‐0.99 worse to 2.45 better)	‐	91 (1 RCT)	⊕⊕⊝⊝ LOWa,c
Other outcomes	No results could be analysed for quality of life, exacerbations, adverse events, unscheduled visits to a healthcare provider or school/work absences
*The risk in the intervention group (and its 95% confidence interval) is based on assumed risk in the comparison group and the relative effect of the intervention (and its 95% CI) ACT: Asthma Control Test (range 0 to 25; higher is better); CI: confidence interval; OR: odds ratio; RCT: randomised controlled trial; RR: risk ratio; SDs: standard deviations
GRADE Working Group grades of evidence High quality: We are very confident that the true effect lies close to the estimate of effect Moderate quality: We are moderately confident in the effect estimate: The true effect is likely to be close to the estimate of effect but may be substantially different Low quality: Our confidence in the effect estimate is limited: The true effect may be substantially different from the estimate of effect Very low quality: We have very little confidence in the effect estimate: The true effect is likely to be substantially different from the estimate of effect

^aConfidence intervals include no difference. Downgraded once

^bAlthough participants in both studies were unblinded, inhaler technique was rated by a blinded assessor, and both groups received an intervention. Not downgraded

^cHigh risk of bias for performance and detection. Downgraded once